Individual
KATHLEEN TREACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
731 MAIN ST STE 122, MONROE, CT 06468-2872
(203) 261-7090
(888) 856-3413
Mailing address
1351 WASHINGTON BLVD, STAMFORD, CT 06902-2419
(203) 621-3700
(203) 332-0376
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
060333
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004234877
—
CT
Enumeration date
09/26/2007
Last updated
07/24/2020
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