Provider Demographics
NPI:1619516705
Name:BRERETON, MARIA H (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:H
Last Name:BRERETON
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 1:157 SHORT BEACH RD
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-3528
Mailing Address - Country:US
Mailing Address - Phone:203-980-2398
Mailing Address - Fax:
Practice Address - Street 1:1400 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517-2459
Practice Address - Country:US
Practice Address - Phone:203-248-2116
Practice Address - Fax:203-287-9815
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0107321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical