Provider Demographics
NPI:1427607712
Name:CRICHTON, ELLEN CATHERINE (LMSW)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:CATHERINE
Last Name:CRICHTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-5836
Mailing Address - Country:US
Mailing Address - Phone:860-346-0060
Mailing Address - Fax:860-346-0054
Practice Address - Street 1:556 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1149
Practice Address - Country:US
Practice Address - Phone:203-779-5799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4651104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker