Individual
KATHRYN FAHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 271-4271
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 271-4271
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003230
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023191467
—
CT
Enumeration date
01/27/2014
Last updated
04/24/2026
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