Individual
CHRISTINE O'GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-4825
(860) 358-4457
Mailing address
40 WEST ST, MIDDLETOWN, CT 06457-3008
(860) 840-8190
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00985
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009985
CT DEPARTMENT OF PUBLIC HEALTH
CT
Enumeration date
01/03/2018
Last updated
06/16/2018
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