MEDICARE: DEIRDE MINOR 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	16425	CT

General Provider Information

NPI Number	:	1962115071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEIRDE MINOR LCSW

Provider Business Mailing Address
First Line	:	56 LINDA LN
Second Line	:
City	:	BETHEL
State	:	CT
Zip	:	06801-1632
Country	:	US
Telephone Number	:	203-312-3189
Fax Number	:

Provider Business Practice Location Address
First Line	:	56 LINDA LN
Second Line	:
City	:	BETHEL
State	:	CT
Zip	:	06801-1632
Country	:	US
Telephone Number	:	203-312-3189
Fax Number	:

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

Provider Enumeration Date	:	01/04/2023
Last Update Date	:	02/27/2026

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Directions to “ DEIRDE MINOR LCSW” Practice Location

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