Healthcare Provider Details

I. General information

NPI: 1659306033
Provider Name (Legal Business Name): MARGARET KIRKPATRICK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 WILLIAM ST
MIDDLETOWN CT
06457-3295
US

IV. Provider business mailing address

267 WILLIAM ST
MIDDLETOWN CT
06457-3295
US

V. Phone/Fax

Practice location:
  • Phone: 860-266-3816
  • Fax:
Mailing address:
  • Phone: 860-266-3816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number002395
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number002395
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: