Provider Demographics
NPI:1851339782
Name:GOGUEN, DENNIS AUREL (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:AUREL
Last Name:GOGUEN
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-2418
Mailing Address - Country:US
Mailing Address - Phone:860-304-2382
Mailing Address - Fax:
Practice Address - Street 1:428 LONG HILL RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3811
Practice Address - Country:US
Practice Address - Phone:860-391-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2020-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0060631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical