Provider Demographics
NPI:1649988155
Name:WYSOCKI, BRYTNIE (LCSW)
Entity type:Individual
Prefix:
First Name:BRYTNIE
Middle Name:
Last Name:WYSOCKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BRYTNIE
Other - Middle Name:
Other - Last Name:AHERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:562 FENN RD
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-1718
Mailing Address - Country:US
Mailing Address - Phone:860-819-5008
Mailing Address - Fax:
Practice Address - Street 1:136 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-3451
Practice Address - Country:US
Practice Address - Phone:860-313-5150
Practice Address - Fax:860-521-1280
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0125641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical