Provider Demographics
NPI:1184042913
Name:CLANCY, CAITLIN (MSW)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:CLANCY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 GREENHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-2090
Mailing Address - Country:US
Mailing Address - Phone:860-575-1671
Mailing Address - Fax:860-767-8800
Practice Address - Street 1:158 WESTBROOK RD
Practice Address - Street 2:SUITE 7
Practice Address - City:ESSEX
Practice Address - State:CT
Practice Address - Zip Code:06426-1553
Practice Address - Country:US
Practice Address - Phone:860-575-1671
Practice Address - Fax:860-767-8800
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker