Healthcare Provider Details

I. General information

NPI: 1235087065
Provider Name (Legal Business Name): CONCUSSED. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 STONEY BROOK DR
WATERFORD CT
06385-1518
US

IV. Provider business mailing address

1000 BOSTON POST RD # 1041
OLD SAYBROOK CT
06475-2142
US

V. Phone/Fax

Practice location:
  • Phone: 860-322-6302
  • Fax: 860-854-2204
Mailing address:
  • Phone: 860-322-6302
  • Fax: 860-854-2204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CAITLIN WARD
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 860-322-6302