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NPI 1902949886

NPI 1902949886 : GEORGETTE CAMPANO CAMPANO WOOD LPC MENTAL HEALTH CO : BRANFORD, CT

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General NPI Number Information
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    NPI Number           |    1902949886
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    Entity Type          |    Individual 
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    Provider Name        |    GEORGETTE CAMPANO CAMPANO WOOD LPC MENTAL HEALTH CO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/14/2007
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    250 WEST MAIN ST SUITE 14
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    City                 |    BRANFORD
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    State                |    CT
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    Zip                  |    06405-4032
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    Country              |    US
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    Telephone            |    203-480-3757
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    Fax                  |    203-481-9536
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Provider Business Mailing Address
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    Address Line         |    250 WEST MAIN ST SUITE 14
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    City                 |    BRANFORD
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    State                |    CT
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    Zip                  |    06405-4032
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    Country              |    US
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    Telephone            |    203-480-3757
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    Fax                  |    203-481-9536
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    001237
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    License Number State |    CT
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Taxonomy #2
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    001237
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    License Number State |    CT
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