| Alston Clinical Private Practice Pllc | |
|
28 School St East Granby CT 06026-9769 | |
| (860) 836-2278 | |
| Not Available |
| Full Name | Alston Clinical Private Practice Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 28 School St, East Granby, Connecticut |
| Authorized Official Name and Position | Vickie Alston (OWNER/PROVIDER) |
| Authorized Official Contact | 8608362278 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alston Clinical Private Practice Pllc 17 Wyncairne East Granby CT 06026-9642 Ph: (860) 836-2278 | Alston Clinical Private Practice Pllc 28 School St East Granby CT 06026-9769 Ph: (860) 836-2278 |
| NPI Number | 1346829116 |
|---|---|
| Provider Enumeration Date | 04/07/2021 |
| Last Update Date | 04/07/2021 |
| Certification Date | 04/07/2021 |
| Medicare PECOS PAC ID | 7517360753 |
|---|---|
| Medicare Enrollment ID | O20210726000689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346829116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Vickie B Alston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053618579 PECOS PAC ID: 3577868355 Enrollment ID: I20160217000733 |
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