Healthcare Provider Details

I. General information

NPI: 1760827489
Provider Name (Legal Business Name): ASHLEY MICHELE DEMENNA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 BUG HILL RD
MONROE CT
06468-1709
US

IV. Provider business mailing address

15 BUG HILL RD
MONROE CT
06468-1709
US

V. Phone/Fax

Practice location:
  • Phone: 203-788-6674
  • Fax:
Mailing address:
  • Phone: 203-788-6674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: