Provider Demographics
NPI:1841883196
Name:DENOMME, CAROL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:DENOMME
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:DERISO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:37 CLARK HILL RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712-1011
Mailing Address - Country:US
Mailing Address - Phone:959-230-5013
Mailing Address - Fax:
Practice Address - Street 1:37 CLARK HILL RD
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1011
Practice Address - Country:US
Practice Address - Phone:959-230-5013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0026901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical