Healthcare Provider Details

I. General information

NPI: 1104666767
Provider Name (Legal Business Name): CATHERINE MAY BEAMES LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 BRADLEY RD
MADISON CT
06443-2644
US

IV. Provider business mailing address

2 GREAT HILL CMNS
GUILFORD CT
06437-2572
US

V. Phone/Fax

Practice location:
  • Phone: 203-245-0412
  • Fax:
Mailing address:
  • Phone: 203-848-9147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9864
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: