Provider Demographics
NPI:1992958094
Name:ELLIS-DENBY, ROXANN MARIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ROXANN
Middle Name:MARIE
Last Name:ELLIS-DENBY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROXANN
Other - Middle Name:MARIE
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:500 VINE STREET
Mailing Address - Street 2:HUMAN RESOURCE
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114
Mailing Address - Country:US
Mailing Address - Phone:860-297-0905
Mailing Address - Fax:860-297-0931
Practice Address - Street 1:51 COVENTRY STREET
Practice Address - Street 2:CAPITOL REGION MENTAL HEALTH CENTER
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112
Practice Address - Country:US
Practice Address - Phone:860-297-0922
Practice Address - Fax:860-297-0914
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0067491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical