| Azalea Counseling & Wellness, Llc | |
|
100 Market Sq Suite 16a Newington CT 06111-2921 | |
| (860) 888-2516 | |
| Not Available |
| Full Name | Azalea Counseling & Wellness, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 100 Market Sq, Newington, Connecticut |
| Authorized Official Name and Position | Jennifer Elizabeth Brady (OWNER) |
| Authorized Official Contact | 8608882516 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Azalea Counseling & Wellness, Llc 100 Market Sq Suite 16a Newington CT 06111-2921 Ph: (860) 888-2516 | Azalea Counseling & Wellness, Llc 100 Market Sq Suite 16a Newington CT 06111-2921 Ph: (860) 888-2516 |
| NPI Number | 1003209115 |
|---|---|
| Provider Enumeration Date | 03/13/2015 |
| Last Update Date | 04/26/2019 |
| Medicare PECOS PAC ID | 3779855929 |
|---|---|
| Medicare Enrollment ID | O20170823000124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003209115 | NPI | - | NPPES |
| 004025193 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 008089 (Connecticut) | Secondary |
| Provider Name | Jennifer E Brady |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497918973 PECOS PAC ID: 0941511596 Enrollment ID: I20150623002026 |
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