Provider Demographics
NPI:1003189630
Name:MCCAFFREY, DEANNA SANTILLI (MSW,BA,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:SANTILLI
Last Name:MCCAFFREY
Suffix:
Gender:F
Credentials:MSW,BA,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:150 MEADOW STREET
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-2310
Practice Address - Country:US
Practice Address - Phone:203-723-9599
Practice Address - Fax:203-723-9890
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0082261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
5990834OtherAETNA BEHAVIORAL HEALTH
CT008050268Medicaid
12793884OtherCAQH
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH