Provider Demographics
NPI:1063489359
Name:MAYGLOTHLING, PAUL JAMES (LCSW, BCD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JAMES
Last Name:MAYGLOTHLING
Suffix:
Gender:M
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 SABINA RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1246
Mailing Address - Country:US
Mailing Address - Phone:203-268-7508
Mailing Address - Fax:203-790-4301
Practice Address - Street 1:152 DEER HILL AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7791
Practice Address - Country:US
Practice Address - Phone:203-790-4301
Practice Address - Fax:203-790-4301
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0019761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical