Provider Demographics
NPI:1952469298
Name:CONROY, DOUGLAS JON (LICENCSE CLINICAL SO)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:JON
Last Name:CONROY
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Gender:M
Credentials:LICENCSE CLINICAL SO
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Mailing Address - Street 1:SOUTHWEST CT MENTAL HEALTH ATTN SANDRA GRAZYNSKI
Mailing Address - Street 2:1635 CENTRAL AVENUE ROOM 213
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610
Mailing Address - Country:US
Mailing Address - Phone:203-551-7660
Mailing Address - Fax:203-551-7481
Practice Address - Street 1:SOUTHWEST CT MENTAL HEALTH ATTN SANDRA GRAZYNSKI
Practice Address - Street 2:1635 CENTRAL AVENUE ROOM 213
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610
Practice Address - Country:US
Practice Address - Phone:203-551-7660
Practice Address - Fax:203-551-7481
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CT0044021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical