Provider Demographics
NPI:1063858942
Name:ZAGRES, JAMES (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:ZAGRES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CHASE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06704-1408
Mailing Address - Country:US
Mailing Address - Phone:203-753-2153
Mailing Address - Fax:
Practice Address - Street 1:22 CHASE RIVER RD
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06704-1408
Practice Address - Country:US
Practice Address - Phone:203-753-2153
Practice Address - Fax:203-756-6032
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0082961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical