Provider Demographics
NPI:1104998491
Name:MESSECAR, GARY W (LCSW)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:W
Last Name:MESSECAR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 SHADY LANE
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:CT
Mailing Address - Zip Code:06238-1429
Mailing Address - Country:US
Mailing Address - Phone:860-742-5874
Mailing Address - Fax:
Practice Address - Street 1:27 HARTFORD TURNPIKE
Practice Address - Street 2:SUITE 204
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-5245
Practice Address - Country:US
Practice Address - Phone:860-533-1070
Practice Address - Fax:860-533-1070
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000586104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT800001039Medicare ID - Type Unspecified