Provider Demographics
NPI:1972386894
Name:MORAN-DILLON, KRISTEN COFFEY (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:COFFEY
Last Name:MORAN-DILLON
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 1:24 WAVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06480-1842
Mailing Address - Country:US
Mailing Address - Phone:860-573-3002
Mailing Address - Fax:
Practice Address - Street 1:24 WAVERLY AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:CT
Practice Address - Zip Code:06480-1842
Practice Address - Country:US
Practice Address - Phone:860-573-3002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker