Healthcare Provider Details

I. General information

NPI: 1669187332
Provider Name (Legal Business Name): KRYSTAL LYNN ALFONZETTI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 WEST ST
DANBURY CT
06810-6528
US

IV. Provider business mailing address

20 BRIARCLIFF MNR
BETHEL CT
06801-2627
US

V. Phone/Fax

Practice location:
  • Phone: 203-752-8355
  • Fax:
Mailing address:
  • Phone: 845-406-0289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number014670
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: