Provider Demographics
NPI:1730214628
Name:CALVERT, RICHARD D (MSW, ACSW, LCSW (CT))
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:D
Last Name:CALVERT
Suffix:
Gender:M
Credentials:MSW, ACSW, LCSW (CT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HAPPY ACRES RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-1332
Mailing Address - Country:US
Mailing Address - Phone:860-442-2797
Mailing Address - Fax:
Practice Address - Street 1:255 HEMPSTEAD ST
Practice Address - Street 2:CHILD AND FAMILY AGENCY OF SOUTHEASTERN CT, INC.
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-6204
Practice Address - Country:US
Practice Address - Phone:860-442-2797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0015131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical