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General NPI Number Information
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NPI Number | 1023826500
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Entity Type | Organization
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Legal Business Name | CONNECTICUT MARRIAGE AND FAMILY THERAPY GROUP PLLC
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 83 WOOSTER HTS STE 125
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City | DANBURY
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State | CT
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Zip | 06810-7550
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Country | US
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Telephone | 718-510-2170
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Fax |
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Provider Business Mailing Address
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Address Line | 46 SHERBROOKE DR
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City | SMITHTOWN
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State | NY
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Zip | 11787-4704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MICHELLE ECKHOFF
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Credential | LMFT
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Telephone | 718-510-2170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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