Provider Demographics
NPI:1487297990
Name:FANTOZZI, NATALENA FRANCESA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:NATALENA
Middle Name:FRANCESA
Last Name:FANTOZZI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:NATALENA
Other - Middle Name:FRANCESCA
Other - Last Name:FAZIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:370 LINWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1949
Mailing Address - Country:US
Mailing Address - Phone:860-224-9113
Mailing Address - Fax:
Practice Address - Street 1:370 LINWOOD ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1949
Practice Address - Country:US
Practice Address - Phone:860-224-9113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4668OtherANTHEM