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General NPI Number Information
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NPI Number | 1518001940
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Entity Type | Individual
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Provider Name | MR. MAXIMILIANO SALAZAR
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Gender | Male
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Dates
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Enumeration Date | 02/18/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 55 WINTHROP ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1728
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Country | US
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Telephone | 860-224-8192
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Fax |
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Provider Business Mailing Address
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Address Line | 35 RUSSELL ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1312
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Country | US
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Telephone | 860-229-8887
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Fax | 860-229-8886
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAC 23841
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SCCD 1201
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License Number State | CT
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