Provider Demographics
NPI:1952790628
Name:TRAMUTA, SAMANTHA JANNETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JANNETTE
Last Name:TRAMUTA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 QUASSUK RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-2952
Mailing Address - Country:US
Mailing Address - Phone:203-525-2533
Mailing Address - Fax:
Practice Address - Street 1:51 SHERMAN HILL RD STE A202
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3648
Practice Address - Country:US
Practice Address - Phone:203-525-2533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-17
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT113251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical