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NPI Code Detail

MEDICARE: CONNECTICUT PSYCHIATRIC & WELLNESS CENTER

MEDICARE: CONNECTICUT PSYCHIATRIC & WELLNESS CENTER
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
1104100000XSocial Worker2162CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659736569
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONNECTICUT PSYCHIATRIC & WELLNESS CENTER
Provider Business Mailing Address
First Line : 2446 WHITNEY AVE FL 2
Second Line :
City : HAMDEN
State : CT
Zip : 06518-3233
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2446 WHITNEY AVE FL 2
Second Line :
City : HAMDEN
State : CT
Zip : 06518-3233
Country : US
Telephone Number : 203-298-9005
Fax Number :
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MS. MONICA AVERSA
Credential :
Telephone Number : 203-298-9005
Provider Enumeration Date : 12/18/2015
Last Update Date : 12/18/2015

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Directions to “CONNECTICUT PSYCHIATRIC & WELLNESS CENTER ” Practice Location

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