Basic Information
| Provider Information | |||||||||
| NPI: | 1902269756 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FLYNN | ||||||||
| FirstName: | VALERIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LMSW,MSW,MA,BA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 141 E MAIN ST | ||||||||
| Address2: | 4TH FLOOR ADMINISTRATION | ||||||||
| City: | WATERBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067022310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035749000 | ||||||||
| FaxNumber: | 2035749006 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 PECK RD | ||||||||
| Address2: | TORRINGTON CLINCIAL SERVICES | ||||||||
| City: | TORRINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067906123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606267007 | ||||||||
| FaxNumber: | 8606267014 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2016 | ||||||||
| LastUpdateDate: | 06/20/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 3173 | CT | Y | Behavioral Health & Social Service Providers | Social Worker | 1041S0200X | 071 | CT | N | Behavioral Health & Social Service Providers | Social Worker | School |
ID Information
| ID | Type | State | Issuer | Description | 060669107 | 01 | CT | UBH-OXFORD FREEDOM/LIBERTY WELLMORE GRP/FACILITY | OTHER | 13802948 | 01 | CT | CAQH | OTHER | D339230 TORRINGTON | 01 | CT | BEACONHEALTH STRATEGIES | OTHER | 060669107 | 01 | CT | HEALTHYCT WELLMORE GRP/FACILITY | OTHER | NOT ELIGIBLE | 01 | CT | MHN MANAGE HEALTH NETWORK | OTHER | NOT ELIGIBLE | 01 | CT | MHN TRICARENORTH | OTHER | 060669107 | 01 | CT | OPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY | OTHER | 060669107 | 01 | CT | UBH UNITED HEALTHCARE WELLMORE GRP/FACILITY | OTHER | 071 | 01 | CT | CONNECTICUT STATE DEPT OF EDUCATION-SCHOOL SOCIAL WORKER | OTHER | 060669107 | 01 | CT | AETNA BEHAVIORAL HEALTH WELLMORE GRP/FACILITY | OTHER | 060669107 | 01 | CT | ANTHEM BCBS OF CT WELLMORE GRP/FACILITY | OTHER | 060669107 | 01 | CT | UBH-CONNECTICARE WELLMORE GRP/FACILITY | OTHER | PENDING | 01 | CT | CIGNA BEHAVIORAL HEALTH | OTHER | PENDING | 05 | CT | MEDICAID |