Healthcare Provider Details

I. General information

NPI: 1538931837
Provider Name (Legal Business Name): MICHAEL PARROTT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 12/23/2023
Certification Date: 12/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 NEW PARK AVE STE 102
WEST HARTFORD CT
06110-1142
US

IV. Provider business mailing address

430 NEW PARK AVE STE 102
WEST HARTFORD CT
06110-1142
US

V. Phone/Fax

Practice location:
  • Phone: 203-632-9216
  • Fax:
Mailing address:
  • Phone: 203-632-9216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3573157777
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: