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General NPI Number Information
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NPI Number | 1154052298
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Entity Type | Organization
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Legal Business Name | JOELLE BROHEN LICSW PLLC
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 66 COUNTY HOME RD
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City | THOMPSON
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State | CT
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Zip | 06277-2840
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Country | US
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Telephone | 860-481-2887
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Fax |
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Provider Business Mailing Address
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Address Line | 66 COUNTY HOME RD
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City | THOMPSON
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State | CT
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Zip | 06277-2840
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Country | US
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Telephone | 860-481-2887
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | CHEYENNE MOSELEY
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Credential |
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Telephone | 800-773-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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