Healthcare Provider Details

I. General information

NPI: 1144296815
Provider Name (Legal Business Name): HARBOR HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 SYCAMORE WAY
BRANFORD CT
06405-6551
US

IV. Provider business mailing address

14 SYCAMORE WAY
BRANFORD CT
06405-6551
US

V. Phone/Fax

Practice location:
  • Phone: 203-483-2630
  • Fax: 203-483-2659
Mailing address:
  • Phone: 203-483-2630
  • Fax: 203-483-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0319
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-0193
License Number StateCT

VIII. Authorized Official

Name: MS. ROBERTA J COOK
Title or Position: ACTING CEO
Credential:
Phone: 203-483-2630