Provider Demographics
NPI:1255606075
Name:CARLIN, CHRISTOPHER SEAN (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:SEAN
Last Name:CARLIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BEAVER MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:HADDAM
Mailing Address - State:CT
Mailing Address - Zip Code:06438-1145
Mailing Address - Country:US
Mailing Address - Phone:860-532-0604
Mailing Address - Fax:
Practice Address - Street 1:415 KILLINGWORTH RD
Practice Address - Street 2:SUITE # 9
Practice Address - City:HIGGANUM
Practice Address - State:CT
Practice Address - Zip Code:06441-4370
Practice Address - Country:US
Practice Address - Phone:860-532-0604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical