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Individual

MS. CAROLINE EAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW,MSW,BSW

Contact information

Practice address
141 E MAIN ST, WELLMORE INC-CHILDRENS SERVICES, WATERBURY, CT 06702-2310
(203) 575-0466
(203) 575-1827
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
008242
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008049710
CT
01
060669107
UBH/OXFORD HEALTH LIBERTY/FREEDOM WELLMORE GRP/FACILITY
CT
01
CAQH
12656269
CT
01
D339123- 141 E MAIN
BEACON HEALTH STRATEGIES
CT
01
PENDING
AETNA BEHAVIORAL HEALTH
CT
Enumeration date
03/23/2012
Last updated
05/19/2016
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