Provider Demographics
NPI:1104861954
Name:KIRSCHE, DENNIS ROBERT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:ROBERT
Last Name:KIRSCHE
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 1:86 COLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-3327
Mailing Address - Country:US
Mailing Address - Phone:860-257-0750
Mailing Address - Fax:
Practice Address - Street 1:587 MIDDLE TPKE E
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-3731
Practice Address - Country:US
Practice Address - Phone:860-646-3888
Practice Address - Fax:860-645-4132
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004965104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
2190124OtherCIGNA