| Coastal Counseling Associates, Llc | |
|
149 Durham Rd Ste 31 Madison CT 06443-2664 | |
| (203) 245-1956 | |
| (203) 245-6710 |
| Full Name | Coastal Counseling Associates, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 149 Durham Rd Ste 31, Madison, Connecticut |
| Authorized Official Name and Position | Judy S. Doyle (PRACTICE MANAGER/OWNER) |
| Authorized Official Contact | 2032451956 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Counseling Associates, Llc 149 Durham Rd Ste 31 Madison CT 06443-2664 Ph: (203) 245-1956 | Coastal Counseling Associates, Llc 149 Durham Rd Ste 31 Madison CT 06443-2664 Ph: (203) 245-1956 |
| NPI Number | 1588771935 |
|---|---|
| Provider Enumeration Date | 08/23/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7618938218 |
|---|---|
| Medicare Enrollment ID | O20041026000449 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588771935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | W Dean Pfeifer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487628624 PECOS PAC ID: 3476555251 Enrollment ID: I20070207000332 |
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