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General NPI Number Information
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NPI Number | 1821495391
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Entity Type | Organization
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Legal Business Name | HALCYON CLINICAL SERVICES, LLC
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Dates
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Enumeration Date | 11/29/2014
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 75 CHARTER OAK AVE
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City | HARTFORD
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State | CT
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Zip | 06106-1903
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Country | US
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Telephone | 860-768-2769
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 280671
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City | EAST HARTFORD
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State | CT
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Zip | 06128-0671
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Country | US
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Telephone | 860-768-2769
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ORLANDO WRIGHT
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Credential | LCSW
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Telephone | 860-768-2769
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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 |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #4
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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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