Healthcare Provider Details

I. General information

NPI: 1851407985
Provider Name (Legal Business Name): NANCY GENNETT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 HIGHLAND ST NEW BRITIAN GENERAL HOSPITAL SUBSTANCE ABUSE SERVICES
NEW BRITAIN CT
06052-2013
US

IV. Provider business mailing address

33 HIGHLAND ST NEW BRITIAN GENERAL HOSPITAL SUBSTANCE ABUSE SERVICES
NEW BRITAIN CT
06052-2013
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-9985
  • Fax: 860-826-4995
Mailing address:
  • Phone: 860-224-9985
  • Fax: 860-826-4995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number000555
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: