Meditelecare Of Connecticut PLLC
Psychologist, Clinical in Middletown, CT. Organization (NPI-2).
NPI number1699365007
StatusActive
Last updated in NPPESJan 20, 2021
Details
- NPI
- 1699365007
- Entity type
- Organization (NPI-2)
- Legal business name
- Meditelecare Of Connecticut PLLC
- Organization subpart
- No
- Enumeration date
- Jan 20, 2021
- Certification date
- Jan 20, 2021
- Last updated
- Jan 20, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | – | – | Yes |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | |
| 2084P0805X | – | – | ||
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
213 Court St Fl 6Middletown, CT 06457-3346
Phone 860-788-6404 · Fax 860-829-0495
Mailing address
Po Box 1595Middletown, CT 06457-8095
Phone 860-788-6404 · Fax 860-829-0495
Authorized official
Teresa Trojanowski
Director Of Revenue Cycle
8607886404
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