Provider Demographics
NPI:1073035465
Name:APPLEBAUM-DOMINICK, EVE MELISSA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EVE
Middle Name:MELISSA
Last Name:APPLEBAUM-DOMINICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 STEEP HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-1922
Mailing Address - Country:US
Mailing Address - Phone:203-701-9475
Mailing Address - Fax:
Practice Address - Street 1:155 STEEP HILL RD.
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:CT
Practice Address - Zip Code:06883
Practice Address - Country:US
Practice Address - Phone:203-701-9475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT98391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical