Healthcare Provider Details

I. General information

NPI: 1265011308
Provider Name (Legal Business Name): KATELYN R MORENCY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 E MAIN ST
WATERBURY CT
06702-2310
US

IV. Provider business mailing address

943 GRAND AVE
NEW HAVEN CT
06511-4984
US

V. Phone/Fax

Practice location:
  • Phone: 203-574-9000
  • Fax:
Mailing address:
  • Phone: 617-482-2520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number009880
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: