Provider Demographics
NPI:1184083164
Name:RICHENTHAL, KATE A (LCSW)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:A
Last Name:RICHENTHAL
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 1:949 BRIDGEPORT AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3142
Mailing Address - Country:US
Mailing Address - Phone:203-878-6365
Mailing Address - Fax:203-301-2397
Practice Address - Street 1:949 BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3142
Practice Address - Country:US
Practice Address - Phone:203-878-6365
Practice Address - Fax:203-301-2397
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0097041041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004039244Medicaid
CT008064367Medicaid
CT13815472OtherCAQH
CT060669107OtherUBH-OXFORD FREEDOM/LIBERTY WELLMORE GRP/FACILITY
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CTNOT ELIGIBLEOtherMHN TRICARENORTH
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CTNOT ELIGIBLEOtherMHN MANAGED HEALTH NETWORK
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT060669107OtherUBH-CONNECTICARE WELLMORE GRP/FACILITY
CTNOT ELIGIBLEMedicare PIN