Provider Demographics
NPI:1740686724
Name:MCAVOY, CAITLIN JC (LCSW)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:JC
Last Name:MCAVOY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:J
Other - Last Name:CROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:51 DEPOT ST
Mailing Address - Street 2:SUITE 202 UNIT D
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795
Mailing Address - Country:US
Mailing Address - Phone:203-465-2869
Mailing Address - Fax:877-805-9529
Practice Address - Street 1:51 DEPOT ST
Practice Address - Street 2:SUITE 202 UNIT D
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795
Practice Address - Country:US
Practice Address - Phone:203-465-2869
Practice Address - Fax:877-805-9529
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1679104100000X
CT97381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008060327Medicaid
CT060669107OtherUNITED BEHAVIORAL HEALTH
CT060669107OtherUBH-UNITED HEALTHCARE
CT1361179OtherCAQH
CT060669107OtherANTHEM BCBS OF CT- WELLMORE GRP/FACILITY
CTD339210-WATERBURYOtherBEACON HEALTH STRATEGIES
CT060669107OtherUBH OXFORD FREEDOM/LIBERTY
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CT008060327Medicaid
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CTNOT ELIGIBLEOtherMHN-MANAGED HEALTH NETWORK
CTNOT ELIGIBLEOtherMHN-TRICARE NORTH
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT060669107OtherUBH- CONNECTICARE WELLMORE GRP/FACILITY