Healthcare Provider Details

I. General information

NPI: 1154337004
Provider Name (Legal Business Name): KERIN B FOLEY MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 08/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 WATERTOWN RD
THOMASTON CT
06787
US

IV. Provider business mailing address

670 MAIN ST
PLYMOUTH CT
06782-2237
US

V. Phone/Fax

Practice location:
  • Phone: 203-819-0789
  • Fax:
Mailing address:
  • Phone: 203-314-8844
  • Fax:

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: