Healthcare Provider Details

I. General information

NPI: 1821561234
Provider Name (Legal Business Name): PAT DEER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

496 MAIN ST STE 3
WINSTED CT
06098-1507
US

IV. Provider business mailing address

22 ALBOUGH RD
BARKHAMSTED CT
06063-3370
US

V. Phone/Fax

Practice location:
  • Phone: 203-770-5883
  • Fax:
Mailing address:
  • Phone: 203-770-5883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. PATRICIA E DEER
Title or Position: OWNER
Credential: LPC
Phone: 203-770-5883