Provider Demographics
NPI:1588937718
Name:WENDY A MCCAFFERY, LLC
Entity type:Organization
Organization Name:WENDY A MCCAFFERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MCCAFFERY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-293-4305
Mailing Address - Street 1:178 MILL HILL TER
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06890-1230
Mailing Address - Country:US
Mailing Address - Phone:203-293-4305
Mailing Address - Fax:203-842-2194
Practice Address - Street 1:178 MILL HILL TER
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:CT
Practice Address - Zip Code:06890-1230
Practice Address - Country:US
Practice Address - Phone:203-293-4305
Practice Address - Fax:203-842-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-19
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007628251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health