Provider Demographics
NPI:1710630132
Name:SEGURA, CECILIA CATHERINE (LCSW)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:CATHERINE
Last Name:SEGURA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:CATHERINE
Other - Last Name:SEGURA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:103 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-4363
Mailing Address - Country:US
Mailing Address - Phone:917-863-4159
Mailing Address - Fax:
Practice Address - Street 1:103 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-4363
Practice Address - Country:US
Practice Address - Phone:917-863-4159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0115951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical