Barbara J. Fasulo, Lcsw, Llc | |
2257 Silas Deane Hwy Rocky Hill CT 06067-2328 | |
(860) 416-5288 | |
Not Available |
Full Name | Barbara J. Fasulo, Lcsw, Llc |
---|---|
Speciality | Community/Behavioral Health |
Location | 2257 Silas Deane Hwy, Rocky Hill, Connecticut |
Authorized Official Name and Position | Barbara J. Fasulo (OWNER) |
Authorized Official Contact | 8604165288 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Barbara J. Fasulo, Lcsw, Llc 2257 Silas Deane Hwy Rocky Hill CT 06067-2328 Ph: (860) 416-5288 | Barbara J. Fasulo, Lcsw, Llc 2257 Silas Deane Hwy Rocky Hill CT 06067-2328 Ph: (860) 416-5288 |
NPI Number | 1447916622 |
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Provider Enumeration Date | 11/12/2021 |
Last Update Date | 11/14/2021 |
Certification Date | 11/14/2021 |
Medicare PECOS PAC ID | 9032509641 |
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Medicare Enrollment ID | O20211214000037 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447916622 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Barbara J Fasulo |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1952883258 PECOS PAC ID: 0941690556 Enrollment ID: I20211214000052 |
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