MEDICARE: CADTC PARTNERS LLC

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	101YM0800X	Mental Health Counselor	364SPO809X	CT

General Provider Information

NPI Number	:	1912356205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CADTC PARTNERS LLC

Provider Business Mailing Address
First Line	:	70 N MAIN ST
Second Line	:	POB 1215
City	:	SHARON
State	:	CT
Zip	:	06069-2074
Country	:	US
Telephone Number	:	860-397-5032
Fax Number	:

Provider Business Practice Location Address
First Line	:	1031 FARMINGTON AVE
Second Line	:
City	:	FARMINGTON
State	:	CT
Zip	:	06032-1576
Country	:	US
Telephone Number	:	860-677-2550
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NEIL LEIBOWITZ
Credential	:	MD
Telephone Number	:	860-677-2550

Provider Enumeration Date	:	06/07/2016
Last Update Date	:	06/07/2016

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Directions to “CADTC PARTNERS LLC ” Practice Location

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