MEDICARE: BENEDICTE AARESTRUP LMFT

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
1	106H00000X	Marriage & Family Therapist	2099	CT

General Provider Information

NPI Number	:	1801442447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENEDICTE AARESTRUP LMFT

Provider Business Mailing Address
First Line	:	267 VIEW STREET, 3 FLOOR
Second Line	:	NEW HAVEN CT
City	:	NEW HAVEN
State	:	CT
Zip	:	06511
Country	:	US
Telephone Number	:	207-590-0945
Fax Number	:

Provider Business Practice Location Address
First Line	:	288 FRONT STREET, NEW HAVEN CT
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06513-0651
Country	:	US
Telephone Number	:	475-224-1172
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2019
Last Update Date	:	08/09/2019

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