Provider Demographics
NPI:1609272228
Name:CATHOLIC CHARLIES
Entity type:Organization
Organization Name:CATHOLIC CHARLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:
Authorized Official - Last Name:MELGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-952-9253
Mailing Address - Street 1:32 KOSSUTH ST
Mailing Address - Street 2:APT 3
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-4352
Mailing Address - Country:US
Mailing Address - Phone:203-952-9253
Mailing Address - Fax:
Practice Address - Street 1:32 KOSSUTH ST
Practice Address - Street 2:APT 3
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-4352
Practice Address - Country:US
Practice Address - Phone:203-724-7537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health