MEDICARE: KITTY BHIDE MSW LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	001207	CT

General Provider Information

NPI Number	:	1811096928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KITTY BHIDE MSW LCSW

Provider Business Mailing Address
First Line	:	1389 WEST MAIN STREET
Second Line	:	SUITE 210
City	:	WATERBURY
State	:	CT
Zip	:	06708-3115
Country	:	US
Telephone Number	:	203-573-1291
Fax Number	:	203-754-5646

Provider Business Practice Location Address
First Line	:	1389 WEST MAIN STREET
Second Line	:	SUITE 210
City	:	WATERBURY
State	:	CT
Zip	:	06708-3115
Country	:	US
Telephone Number	:	203-573-1291
Fax Number	:	203-754-5646

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/08/2007

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