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General NPI Number Information
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NPI Number | 1497115596
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Entity Type | Individual
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Provider Name | CARRIE MICHELLE GARRIGUS LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 73 CEDAR ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1301
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Country | US
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Telephone | 860-224-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 823 GATEWAY CENTER WAY
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City | SAN DIEGO
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State | CA
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Zip | 92102-4541
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Country | US
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Telephone | 619-515-2300
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Fax | 619-269-0674
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 88758
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License Number State | CA
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