| Theresa Mamie Charles I, | |
|
542 Longhill Road, Groton, CT 06340 | |
| (866) 448-4993 | |
| Not Available |
| Full Name | Theresa Mamie Charles I |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 542 Longhill Road, Groton, Connecticut |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255769576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 060886125 (Connecticut) | Primary |
| 101YM0800X | Counselor - Mental Health | 060886125 (* (Not Available)) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa Mamie Charles I, 542 Long Hill Rd, Groton, CT 06340-4108 Ph: (860) 448-4993 | Theresa Mamie Charles I, 542 Longhill Road, Groton, CT 06340 Ph: (866) 448-4993 |
Dr. Lisa Marie Tonnessen, PHD Counselor Medicare: Medicare Enrolled Practice Location: 616 Goldstar Hgwy, Shoreline Counseling, Groton, CT 06340 Phone: 860-449-0200 Fax: 860-449-1954 | |
Michael John Formica, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 616 Gold Star Hwy, Groton, CT 06340 Phone: 860-449-0200 Fax: 860-449-1954 | |
Ms. Susannah Jane Forte Stahr, MS, MFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 591 Poquonnock Rd, Groton, CT 06340 Phone: 860-449-8217 Fax: 860-449-8323 | |
Dr. F. Henry Doran, D.MIN, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 616 Gold Star Hwy, Groton, CT 06340 Phone: 860-449-0200 Fax: 860-449-1954 | |
Ms. Jessica M Gagnon, LCSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 428 Long Hill Rd Ste 201, Groton, CT 06340 Phone: 860-705-2840 | |
Rachel Marie Powell, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 611a Long Hill Rd, Groton, CT 06340 Phone: 860-405-8097 Fax: 860-572-4986 | |
Mrs. Nancy Vail Anstrom, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 616 Goldstar Hwy, Groton, CT 06340 Phone: 860-449-0200 Fax: 860-449-1954 |