Provider Demographics
NPI:1073314944
Name:DWYER, DANIEL N (LCSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:N
Last Name:DWYER
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 STRAITS TPKE # C107
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-2865
Mailing Address - Country:US
Mailing Address - Phone:475-235-9743
Mailing Address - Fax:203-886-1181
Practice Address - Street 1:900 STRAITS TPKE # C107
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2865
Practice Address - Country:US
Practice Address - Phone:475-235-9743
Practice Address - Fax:203-886-1181
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0150011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical