Provider Demographics
NPI:1952540528
Name:MEDWIN, CARI LAUREN (MSW)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:LAUREN
Last Name:MEDWIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WOODS RD.
Mailing Address - Street 2:
Mailing Address - City:BETHNY
Mailing Address - State:CT
Mailing Address - Zip Code:06524
Mailing Address - Country:US
Mailing Address - Phone:203-891-6937
Mailing Address - Fax:
Practice Address - Street 1:15 WOODS RD
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:CT
Practice Address - Zip Code:06524-3103
Practice Address - Country:US
Practice Address - Phone:203-891-6937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO311441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical