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General NPI Number Information
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NPI Number | 1700089257
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Entity Type | Organization
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Legal Business Name | CLIFFORD BEERS CLINIC
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 370 JAMES ST
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City | NEW HAVEN
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State | CT
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Zip | 06513-3089
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Country | US
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Telephone | 203-777-8648
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Fax |
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Provider Business Mailing Address
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Address Line | 249 THORNTON ST
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City | HAMDEN
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State | CT
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Zip | 06517-1325
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Country | US
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Telephone | 203-230-5823
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. MARTHA LUCIA PLAZAS
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Credential | LMFT
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Telephone | 203-777-8648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 000689
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License Number State | CT
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