Healthcare Provider Details
I. General information
NPI: 1902906886
Provider Name (Legal Business Name): S.A.P. SERVICES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2006
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9 LEDYARD AVE
BLOOMFIELD CT
06002-3353
US
IV. Provider business mailing address
9 LEDYARD AVE
BLOOMFIELD CT
06002-3353
US
V. Phone/Fax
- Phone: 860-478-5399
- Fax: 860-904-9197
- Phone: 860-478-5399
- Fax: 860-298-0855
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 000343 |
| License Number State | CT |
VIII. Authorized Official
Name: DR.
ALBERT
F. A.
YOUNG
SR.
Title or Position: OWNER
Credential: P.HD, LADC, SAP.
Phone: 860-478-5399