| NPI | 1285040675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN W SIMONCELLI Executive Director 860-805-2267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 1041C0700X Social Worker Clinical | |
| 104100000X Social Worker | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2015-01-12 |