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General NPI Number Information
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NPI Number | 1992335616
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Entity Type | Individual
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Provider Name | AMANDA BEGIN MA, LADC
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Gender | Female
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Dates
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Enumeration Date | 01/22/2020
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Last Update Date | 01/22/2020
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Provider Practice Location Address
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Address Line | 270 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06032-1909
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Country | US
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Telephone | 866-887-6864
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Fax |
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Provider Business Mailing Address
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Address Line | 148 VALLEY VIEW DR
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City | WETHERSFIELD
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State | CT
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Zip | 06109-2622
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Country | US
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Telephone | 860-912-0064
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Fax |
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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 | 001360
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License Number State | CT
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