Provider Demographics
NPI:1578196259
Name:MIGENES, HARRY (LCSW-R)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:
Last Name:MIGENES
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 WESTPORT RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-1329
Mailing Address - Country:US
Mailing Address - Phone:203-522-1212
Mailing Address - Fax:203-261-1329
Practice Address - Street 1:193 WESTPORT RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:CT
Practice Address - Zip Code:06612-1329
Practice Address - Country:US
Practice Address - Phone:203-522-1212
Practice Address - Fax:203-261-1329
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0022151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical