| NPI | 1669001517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA KING Authorized 860-322-6712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TC0700X Psychologist, Clinical | |
| 103TC1900X Psychologist, Counseling | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 364SA2100X Clinical Nurse Specialist, Acute Care | |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2023-07-18 |