Healthcare Provider Details

I. General information

NPI: 1427607712
Provider Name (Legal Business Name): ELLEN CATHERINE CRICHTON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 WASHINGTON AVE
NORTH HAVEN CT
06473-1149
US

IV. Provider business mailing address

331 MAIN ST
NORWICH CT
06360-5836
US

V. Phone/Fax

Practice location:
  • Phone: 203-779-5799
  • Fax:
Mailing address:
  • Phone: 860-346-0060
  • Fax: 860-346-0054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4651
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: