| NPI | 1275321846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAITLYN BOUCHARD Manager 860-965-5306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 103TC1900X Psychologist, Counseling | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-04-25 |
| Last Update Date | 2025-04-25 |