Amanda Jean Nowak, LPC | |
134 Main St, Putnam, CT 06260-1920 | |
(860) 926-0142 | |
(860) 413-0919 |
Full Name | Amanda Jean Nowak |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 134 Main St, Putnam, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598178865 | NPI | - | NPPES |
004040564 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 003392 (Connecticut) | Primary |
Entity Name | Preservation Within Therapy Practice, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891313797 PECOS PAC ID: 4082050091 Enrollment ID: O20240313001677 |
Mailing Address | Practice Location Address |
---|---|
Amanda Jean Nowak, LPC Po Box 633, Putnam, CT 06260-0633 Ph: (860) 926-0142 | Amanda Jean Nowak, LPC 134 Main St, Putnam, CT 06260-1920 Ph: (860) 926-0142 |
Morgan Savino, Counselor Medicare: Not Enrolled in Medicare Practice Location: 391 Pomfret St, Putnam, CT 06260 Phone: 886-073-1552 Fax: 860-735-5536 | |
Mary Mcginn, Counselor Medicare: Not Enrolled in Medicare Practice Location: 391 Pomfret St, Putnam, CT 06260 Phone: 860-963-4971 Fax: 860-963-4979 | |
Jennifer Salvas, Counselor Medicare: Not Enrolled in Medicare Practice Location: 320 Pomfret St, Putnam, CT 06260 Phone: 860-963-6385 | |
Clara C Costabile, Counselor Medicare: Not Enrolled in Medicare Practice Location: 391 Pomfret St, Putnam, CT 06260 Phone: 860-731-5522 Fax: 860-731-5536 | |
Victoria Sousa, Counselor Medicare: Not Enrolled in Medicare Practice Location: 391 Pomfret St, Putnam, CT 06260 Phone: 860-963-4971 Fax: 860-963-4979 | |
Michelle Lee Loucraft, Counselor Medicare: Not Enrolled in Medicare Practice Location: 320 Pomfret St, Putnam, CT 06260 Phone: 860-963-6385 | |
Jennifer A Roberts, Counselor Medicare: Not Enrolled in Medicare Practice Location: 391 Pomfret St, Putnam, CT 06260 Phone: 860-963-4971 Fax: 860-731-5536 |