Basic Information
| Provider Information | |||||||||
| NPI: | 1649662313 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARENS | ||||||||
| FirstName: | LORI | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 W MAIN ST | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | BRANFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064054032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2036403521 | ||||||||
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| Practice Location | |||||||||
| Address1: | 141 E MAIN ST FL 4 | ||||||||
| Address2: | |||||||||
| City: | WATERBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035749000 | ||||||||
| FaxNumber: | 2035749006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2015 | ||||||||
| LastUpdateDate: | 05/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 008943 | CT | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 060669107 | 01 | CT | UBH-OXFORD/LIBERTY/FREEDOM WELLMORE GRP/FACILITY | OTHER | 060669107 | 01 | CT | UNITED BEHAVIORAL HEALTH- WELLMORE GRP/FACILITY | OTHER | 060669107 | 01 | CT | UBH-CONNECTICARE WELLMORE GRP/FACILITY | OTHER | PENDING | 01 | CT | CIGNA BEHAVIORAL HEALTH (WELLMORE) | OTHER | 060669107 | 01 | CT | UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY | OTHER | PENDING | 01 | CT | MHN TRICARENORTH (WELLMORE) | OTHER | 13523501 | 01 | CT | CAQH | OTHER | PENDING | 01 | CT | MHN MANAGED HEALTH NETWORK- WELLMORE, INC | OTHER | 008061265 | 05 | CT | MEDICAID | 060669107 | 01 | CT | ANTHEM BCBS CT- WELLMORE GRP/FACILITY | OTHER | 060669107 | 01 | CT | HEALTHYCT WELLMORE GRP/FACILITY | OTHER |