Provider Demographics
NPI:1780289843
Name:KATHLEEN PARISEAU, LCSWLLC
Entity type:Organization
Organization Name:KATHLEEN PARISEAU, LCSWLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PARISEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:413-478-5861
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06083-0404
Mailing Address - Country:US
Mailing Address - Phone:413-478-5861
Mailing Address - Fax:
Practice Address - Street 1:20 PUTNAM DR
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-6125
Practice Address - Country:US
Practice Address - Phone:413-478-5861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty