Mr Richard Michael Gorman Iii, LPC | |
18 Commodore Hull Dr, Derby, CT 06418-2255 | |
(860) 830-7967 | |
Not Available |
Full Name | Mr Richard Michael Gorman Iii |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 18 Commodore Hull Dr, Derby, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851863294 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 003630 (Connecticut) | Primary |
Entity Name | Key Therapy Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114393493 PECOS PAC ID: 6204185010 Enrollment ID: O20180827003149 |
Mailing Address | Practice Location Address |
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Mr Richard Michael Gorman Iii, LPC 18 Commodore Hull Dr, Derby, CT 06418-2255 Ph: (860) 830-7967 | Mr Richard Michael Gorman Iii, LPC 18 Commodore Hull Dr, Derby, CT 06418-2255 Ph: (860) 830-7967 |
Rosemary O Mcbrien, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 30 Elizabeth St, Derby, CT 06418 Phone: 203-954-0543 | |
Thomas Heffernan, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 130 Division Street, Griffin Hospital, Derby, CT 06418 Phone: 203-732-7550 Fax: 203-732-1550 | |
Mrs. Annette Bonomo, MS,ATR-BC Counselor Medicare: Not Enrolled in Medicare Practice Location: 30 Elizabeth St, Parent Child Resource Center, Derby, CT 06418 Phone: 203-954-0543 | |
Jessica Borges, Counselor Medicare: Medicare Enrolled Practice Location: 17 Elizabeth St, Derby, CT 06418 Phone: 475-777-5905 | |
Amanda Furegno, MA, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Elizabeth St, Derby, CT 06418 Phone: 203-446-2252 | |
Susan J Braun, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-732-7550 | |
Lindsay Walker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 246 Derby Ave, Derby, CT 06418 Phone: 203-685-8862 |