Provider Demographics
NPI:1467699793
Name:ALDRICH, VICKY S (LCSW)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:S
Last Name:ALDRICH
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 1:200 RETREAT AVE
Mailing Address - Street 2:HARTFROD HOSPITAL PSYCHIATRY DEPARTMENT
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-3309
Mailing Address - Country:US
Mailing Address - Phone:860-696-0014
Mailing Address - Fax:860-696-0030
Practice Address - Street 1:200 RETREAT AVE
Practice Address - Street 2:HARTFROD HOSPITAL PSYCHIATRY DEPARTMENT
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3309
Practice Address - Country:US
Practice Address - Phone:860-696-0014
Practice Address - Fax:860-696-0030
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0016631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical