Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Dougherty, LCSW

Individual provider Social Worker · NPI 1023615614

Kelly Dougherty, LCSW is a Clinical Social Worker in Bridgeport, Connecticut. Qualified in 2020, 6 years ago. Licensed in Connecticut.

Years since qualifying
6
Licensed in
CT
In the registry since
2020
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

2625 Park Ave Unit 2J
Bridgeport, CT 06604-1337
Phone: (203) 615-1405
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 013971 (CT)
Social Worker Taxonomy 104100000X (CT)

Record details

NPI number1023615614
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedOctober 6, 2020
Last updated in NPPESOctober 29, 2025
Certification dateOctober 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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