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 | 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 | |
363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
364SA2100X Clinical Nurse Specialist Acute Care | |
Enumeration Date | 2020-04-03 |
Last Update Date | 2023-07-18 |