Provider Demographics
NPI:1174813893
Name:HENNESSEY, JOHN FRANCIS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:FRANCIS
Last Name:HENNESSEY
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 1:60 ELM ST
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-3240
Mailing Address - Country:US
Mailing Address - Phone:860-875-0292
Mailing Address - Fax:860-871-4910
Practice Address - Street 1:60 ELM ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3240
Practice Address - Country:US
Practice Address - Phone:860-875-0292
Practice Address - Fax:860-871-4910
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0021691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical