Provider Demographics
NPI:1457186041
Name:BYCZKO, DENISE (LMSW)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:BYCZKO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 WEBB ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR LOCKS
Mailing Address - State:CT
Mailing Address - Zip Code:06096-2516
Mailing Address - Country:US
Mailing Address - Phone:860-301-7735
Mailing Address - Fax:
Practice Address - Street 1:880 BURBANK AVE
Practice Address - Street 2:
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078-1459
Practice Address - Country:US
Practice Address - Phone:860-301-7735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT103451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical