Provider Demographics
NPI:1235558396
Name:DUFFY, MAUREEN BARRETT
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:BARRETT
Last Name:DUFFY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MAUREEN
Other - Middle Name:BARRETT
Other - Last Name:DUFFY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:13 MARK LN
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1138
Mailing Address - Country:US
Mailing Address - Phone:860-563-5607
Mailing Address - Fax:
Practice Address - Street 1:13 MARK LN
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1138
Practice Address - Country:US
Practice Address - Phone:860-563-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0079991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical