| Breakwater Counseling Center, Llc | |
|
1110 Broadbridge Ave Stratford CT 06615-5801 | |
| (203) 693-1169 | |
| Not Available |
| Full Name | Breakwater Counseling Center, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1110 Broadbridge Ave, Stratford, Connecticut |
| Authorized Official Name and Position | Joanne Martin (OWNER/COUNSELOR) |
| Authorized Official Contact | 2036931169 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakwater Counseling Center, Llc 1110 Broadbridge Ave Stratford CT 06615-5801 Ph: (203) 693-1169 | Breakwater Counseling Center, Llc 1110 Broadbridge Ave Stratford CT 06615-5801 Ph: (203) 693-1169 |
| NPI Number | 1821592072 |
|---|---|
| Provider Enumeration Date | 03/22/2018 |
| Last Update Date | 07/24/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821592072 | NPI | - | NPPES |
| CBHP009329 | Other | CT | BEACON HEALTH |
| 003183 | Other | CT | STATE OF CT DPH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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