Provider Demographics
NPI:1821247396
Name:WELCH, IRJA (LCSW)
Entity Type:Individual
Prefix:
First Name:IRJA
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:IRJA
Other - Middle Name:
Other - Last Name:PECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:995 DAY HILL RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-1722
Mailing Address - Country:US
Mailing Address - Phone:860-731-5522
Mailing Address - Fax:860-731-5536
Practice Address - Street 1:587 MIDDLE TPKE E
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-3731
Practice Address - Country:US
Practice Address - Phone:860-646-3888
Practice Address - Fax:860-645-4132
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0076231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical