| NPI | 1215633391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL DECASTRO Member 203-794-4714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP1600X Counselor, Pastoral | |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 103K00000X Behavior Analyst | |
| 1041C0700X Social Worker, Clinical | |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2023-02-01 |