Provider Demographics
NPI:1346304011
Name:ANNINO, GERRY M (LCSW)
Entity Type:Individual
Prefix:
First Name:GERRY
Middle Name:M
Last Name:ANNINO
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 1:35A OLD TOLL RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-1773
Mailing Address - Country:US
Mailing Address - Phone:860-304-5088
Mailing Address - Fax:203-785-0617
Practice Address - Street 1:93 EDWARDS ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3933
Practice Address - Country:US
Practice Address - Phone:203-777-8648
Practice Address - Fax:203-785-0617
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker