| Clearsource Counseling, Pllc | |
|
2900 Main St Ste 3df Stratford CT 06614-4946 | |
| (203) 457-3963 | |
| Not Available |
| Full Name | Clearsource Counseling, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2900 Main St Ste 3df, Stratford, Connecticut |
| Authorized Official Name and Position | Phoebe Musico (MANAGER) |
| Authorized Official Contact | 2039849352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clearsource Counseling, Pllc #1020, 1201 Kings Highway Suite 2 Fairfield CT 06824 Ph: () - | Clearsource Counseling, Pllc 2900 Main St Ste 3df Stratford CT 06614-4946 Ph: (203) 457-3963 |
| NPI Number | 1770239055 |
|---|---|
| Provider Enumeration Date | 02/25/2022 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Medicare PECOS PAC ID | 5698162808 |
|---|---|
| Medicare Enrollment ID | O20220418001425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770239055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Phoebe Ward Gould Musico |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386260040 PECOS PAC ID: 6507253713 Enrollment ID: I20220418001510 |
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