Basic Information
Provider Information
NPI: 1861812778
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRENCH
FirstName: CALIE
MiddleName: MARIE NIEDZWIECKI
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1680 ALBANY AVE
Address2:  
City: HARTFORD
State: CT
PostalCode: 061051001
CountryCode: US
TelephoneNumber: 8602364511
FaxNumber:  
Practice Location
Address1: 675 MAIN ST
Address2:  
City: MIDDLETOWN
State: CT
PostalCode: 064572732
CountryCode: US
TelephoneNumber: 8603476971
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/17/2014
LastUpdateDate: 04/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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