Provider Demographics
NPI:1720454028
Name:SASSO, KATHERINE (LMSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SASSO
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 1:72 CHESTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1201
Mailing Address - Country:US
Mailing Address - Phone:860-908-5030
Mailing Address - Fax:
Practice Address - Street 1:100 JEFFERSON SQ
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1109
Practice Address - Country:US
Practice Address - Phone:860-908-5030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW 2210571041C0700X
CT47351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical