Michelle Rita Doherty, LCSW

Individual provider Active NPI Clinical Social Worker · New Canaan, CT

NPI 1821364514 · NPPES record last updated Mar 29, 2012

Key facts

NPI
1821364514
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
006910 (CT)
Practice address
161 Cherry St
Voices of September 11TH
New Canaan, CT 06840-4827
Phone
(203) 966-3911
Fax
(203) 966-5701
NPI assigned
Mar 27, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
006910CTMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 006910 CT Yes

Addresses

Primary practice location

161 Cherry St
Voices of September 11TH
New Canaan, CT 06840-4827

Mailing address

161 Cherry St
Voices of September 11TH
New Canaan, CT 06840-4827
Phone (203) 966-3911

Other providers in New Canaan, CT

All providers in New Canaan, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.