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General NPI Number Information
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NPI Number | 1649996687
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Entity Type | Organization
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Legal Business Name | WILLIAM CHRISTOPHER BROWN
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 40 MAIN ST N STE 2F
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City | WOODBURY
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State | CT
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Zip | 06798-2966
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Country | US
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Telephone | 860-483-0796
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Fax |
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Provider Business Mailing Address
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Address Line | 98 QUASSUK RD
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City | WOODBURY
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State | CT
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Zip | 06798-2901
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Country | US
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Telephone | 858-761-6851
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Fax |
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Authorized Official
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Title or Position | COORDINATOR
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Name | LUCY IRENE VAIL
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Credential | LMFT
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Telephone | 858-761-6851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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