Healthcare Provider Details

I. General information

NPI: 1780322453
Provider Name (Legal Business Name): BION P HARRIGAN LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2022
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 ELLA T GRASSO BLVD
NEW HAVEN CT
06519-5516
US

IV. Provider business mailing address

4 LEDGE RD
WOODBRIDGE CT
06525-1802
US

V. Phone/Fax

Practice location:
  • Phone: 203-349-9400
  • Fax:
Mailing address:
  • Phone: 978-985-9191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number5499
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: