Healthcare Provider Details

I. General information

NPI: 1013501154
Provider Name (Legal Business Name): MEGAN ANGIOLILLO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 THOMAS AVE
THOMASTON CT
06787-1502
US

IV. Provider business mailing address

124 AETNA AVE
TORRINGTON CT
06790-4426
US

V. Phone/Fax

Practice location:
  • Phone: 203-841-9492
  • Fax:
Mailing address:
  • Phone: 203-841-9492
  • Fax: 860-283-3048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: