Provider Demographics
NPI:1598794984
Name:GUGLIOTTI, JOSEPH R (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:R
Last Name:GUGLIOTTI
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 1:133 SCOVILL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1127
Mailing Address - Country:US
Mailing Address - Phone:860-274-7028
Mailing Address - Fax:203-757-4105
Practice Address - Street 1:133 SCOVILL ST
Practice Address - Street 2:SUITE201
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1127
Practice Address - Country:US
Practice Address - Phone:860-274-7028
Practice Address - Fax:203-757-4105
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0007851041C0700X
CT000135101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT800000195Medicare ID - Type Unspecified