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NPI Code Detail

MEDICARE: LITCHFIELD HILLS CLINICAL SERVICES

MEDICARE: LITCHFIELD HILLS CLINICAL SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1629440151
Entity Type Code : Organization
Provider Name (Legal Business Name) : LITCHFIELD HILLS CLINICAL SERVICES
Provider Business Mailing Address
First Line : 457 BANTAM RD
Second Line :
City : LITCHFIELD
State : CT
Zip : 06759-3225
Country : US
Telephone Number : 917-617-6256
Fax Number :
Provider Business Practice Location Address
First Line : 457 BANTAM RD
Second Line :
City : LITCHFIELD
State : CT
Zip : 06759-3225
Country : US
Telephone Number : 917-617-6256
Fax Number :
Authorized Official
Title or Position : OWNER
Name : REBECCA VATTUONE
Credential : LPC
Telephone Number : 917-617-6256
Provider Enumeration Date : 10/23/2015
Last Update Date : 10/23/2015

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Directions to “LITCHFIELD HILLS CLINICAL SERVICES ” Practice Location

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