| Alaina Brokaw, Lpc, Llc | |
|
49 Tolland Turnpike #203f Manchester CT 06042 | |
| (860) 222-7073 | |
| (860) 215-4180 |
| Full Name | Alaina Brokaw, Lpc, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 49 Tolland Turnpike, Manchester, Connecticut |
| Authorized Official Name and Position | Alaina Brokaw (OWNER) |
| Authorized Official Contact | 8608597949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alaina Brokaw, Lpc, Llc 89 Finley St Manchester CT 06040-5615 Ph: (860) 859-7949 | Alaina Brokaw, Lpc, Llc 49 Tolland Turnpike #203f Manchester CT 06042 Ph: (860) 222-7073 |
| NPI Number | 1720785868 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 11/17/2023 |
| Certification Date | 11/15/2023 |
| Medicare PECOS PAC ID | 5597116574 |
|---|---|
| Medicare Enrollment ID | O20240104001553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720785868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Alaina Jeanne Brokaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487034989 PECOS PAC ID: 6406207489 Enrollment ID: I20240104001689 |
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