Provider Demographics
NPI:1457597551
Name:OLIGINO, DONAMARIE (LCSW)
Entity type:Individual
Prefix:
First Name:DONAMARIE
Middle Name:
Last Name:OLIGINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DONAMARIE
Other - Middle Name:
Other - Last Name:DESANCTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1931 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3506
Mailing Address - Country:US
Mailing Address - Phone:203-384-8681
Mailing Address - Fax:
Practice Address - Street 1:555 BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4749
Practice Address - Country:US
Practice Address - Phone:203-922-1773
Practice Address - Fax:203-924-2334
Is Sole Proprietor?:No
Enumeration Date:2008-12-20
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0054701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical