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Behavioral Health & Social Service Providers Psychologist Clinical

Provider NPI: 1508899212

Organization Information:
Organization is not Subpart
Authorized Official:  MARCI B. KORWIN  PRINCIPAL  860-233-9772

Practice Location:
Tel: 860-233-9772  Fax: 860-236-9402

Business Mailing Address:
Tel: 860-233-9772  Fax: 860-236-9402

NPI Information:
NPI: 1508899212
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N103TC0700XBehavioral Health & Social Service Providers
N103TC2200XBehavioral Health & Social Service Providers
N103T00000XBehavioral Health & Social Service Providers
N103TP2701XBehavioral Health & Social Service Providers
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
N106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
Y101YP2500XBehavioral Health & Social Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 101YP2500X





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