Individual
MS. KATHLEEN E NUGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC,MA,BS
Contact information
Practice address
402 E MAIN ST, WATERBURY, CT 06702-1701
(203) 755-1143
(203) 753-3274
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
101YP2500X
Professional Counselor
Primary
2747
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008058806
—
CT
01
—
060669107
ANTHEM BC BS OF CT WELLMORE GRP/FACILITY
CT
01
—
13549351
CAQH
CT
01
—
D339210 WATERBURY
BEACON HEALTH STRATEGIES
CT
01
—
PENDING
MHN TRICARE NORTH
CT
Enumeration date
09/13/2012
Last updated
05/19/2016
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