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Behavioral Health & Social Service Providers Counselor Professional

Provider NPI: 1821059486

Organization Information:
Organization is not Subpart
Authorized Official:  IRVIN R JENNINGS  EXECUTIVE/MEDICAL DIRECTOR  203-748-5689

Practice Location:
75 WEST ST  DANBURY, CT 06810-6528 US
Tel: 203-748-5689  Fax: 203-790-8183

Business Mailing Address:
75 WEST ST  DANBURY, CT 06810-6528 US
Tel: 203-748-5689  Fax: 203-790-8183

NPI Information:
NPI: 1821059486
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N101YP2500XBehavioral Health & Social Service Providers
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
N106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
Psychiatry & Neurology
N376J00000XNursing Service Related Providers
Y261QM0855XAmbulatory Health Care Facilities
N261QM0801XAmbulatory Health Care Facilities

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 261QM0855X





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