=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306086905
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN ANTHONY VOYTOVICH LPC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2009
-----------------------------------------------------
Last Update Date | 02/23/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 125 SHERMAN AVE
-----------------------------------------------------
City | NEW HAVEN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06511-5236
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-789-3248
-----------------------------------------------------
Fax | 203-789-3251
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 170 BUNKER HILL RD
-----------------------------------------------------
City | GUILFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06437-5003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-605-7894
-----------------------------------------------------
Fax | 203-453-9907
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 001620
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------