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General NPI Number Information
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NPI Number | 1427615053
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Entity Type | Organization
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Legal Business Name | FAMILY COUNSELING OF NEWINGTON, PLLC
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Dates
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Enumeration Date | 05/20/2019
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 39 MARKET SQ FL 2
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City | NEWINGTON
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State | CT
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Zip | 06111-2912
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Country | US
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Telephone | 860-841-2559
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Fax | 960-371-3488
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Provider Business Mailing Address
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Address Line | 39 MARKET SQ FL 2
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City | NEWINGTON
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State | CT
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Zip | 06111-2912
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Country | US
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Telephone | 860-841-2559
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Fax | 960-371-3488
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MITCHELL KENNETH PAGE
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Credential | MSW, LCSW
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Telephone | 860-841-2559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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