Individual
KASANDRA MARBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,BSW,LMSW, LCSW
Contact information
Practice address
30 PECK RD BLDG 2, TORRINGTON CLINICAL SERVICES, TORRINGTON, CT 06790-6123
(860) 626-7007
(860) 626-7014
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
9389
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008060377
—
CT
01
—
071
CONNECTICUT DEPT OF EDUCATION EDUCATOR CERTIFICATE-SCHOOL SOCIAL WORKER
CT
01
—
13671437
CAQH
CT
Enumeration date
07/09/2015
Last updated
06/02/2016
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