Provider Demographics
NPI:1083743488
Name:CAHILL, JOAN D (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:D
Last Name:CAHILL
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:PO BOX 401
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-0401
Mailing Address - Country:US
Mailing Address - Phone:860-628-3963
Mailing Address - Fax:860-628-3966
Practice Address - Street 1:51 N MAIN ST
Practice Address - Street 2:STE. 2 D
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2537
Practice Address - Country:US
Practice Address - Phone:860-628-3963
Practice Address - Fax:860-628-3966
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0002711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT42664OtherPID #
CT6257312OtherUHC PID #
CTP398863OtherPID OXFORD #
CT2212025OtherAETNA EAP PID #
CT4264841OtherPID MAGELLAN #
CT6257312OtherUBH PID #
CT0004264841OtherAETNA PID #
CT192907OtherCOMPSYCHE PID #
CT073423OtherVALUE OPTIONS PID #
CT00387OtherEAP PID #
CT140000271CT02OtherPID #
CT2212025OtherAETNA
170616OtherMHN PID #
CT426484OtherAETNA USHC
CT919201OtherPACIFIC CARE PID #