Provider Demographics
NPI:1770175499
Name:QUIGG, CRYSTAL ANN (LMSW)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ANN
Last Name:QUIGG
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 1:51 LAKESIDE BLVD E UPPR LEVEL
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2958
Mailing Address - Country:US
Mailing Address - Phone:860-488-1509
Mailing Address - Fax:203-756-6032
Practice Address - Street 1:51 LAKESIDE BLVD E UPPR LEVEL
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2958
Practice Address - Country:US
Practice Address - Phone:203-753-2153
Practice Address - Fax:203-756-6032
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5539104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker