Healthcare Provider Details

I. General information

NPI: 1053239277
Provider Name (Legal Business Name): KALLAN MARIE DOYON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HILLSIDE AVE
NAUGATUCK CT
06770-4019
US

IV. Provider business mailing address

78 FINCH AVE
MERIDEN CT
06451-2713
US

V. Phone/Fax

Practice location:
  • Phone: 203-632-9669
  • Fax:
Mailing address:
  • Phone: 203-694-4711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11204
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: