| Asd Center For Therapeutic Services | |
|
415 Killingworth Rd Suite 9a/b Higganum CT 06441-4370 | |
| (860) 532-0604 | |
| (860) 322-4723 |
| Full Name | Asd Center For Therapeutic Services |
|---|---|
| Speciality | Social Worker |
| Location | 415 Killingworth Rd, Higganum, Connecticut |
| Authorized Official Name and Position | Christopher Sean Carlin (FOUNDER/DIRECTOR OF CLINICAL SERVIC) |
| Authorized Official Contact | 8605320604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Asd Center For Therapeutic Services 415 Killingworth Rd Suite 9a/b Higganum CT 06441-4370 Ph: (860) 532-0604 | Asd Center For Therapeutic Services 415 Killingworth Rd Suite 9a/b Higganum CT 06441-4370 Ph: (860) 532-0604 |
| NPI Number | 1174921431 |
|---|---|
| Provider Enumeration Date | 12/18/2014 |
| Last Update Date | 12/18/2014 |
| Medicare PECOS PAC ID | 7911221809 |
|---|---|
| Medicare Enrollment ID | O20150126000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174921431 | NPI | - | NPPES |
| 1255606075 | Other | CT | PERSONAL NPI# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 007775 (Connecticut) | Primary |
| Provider Name | Christopher S Carlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255606075 PECOS PAC ID: 4082938972 Enrollment ID: I20150126000368 |
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