| College Street Counseling Center Llc | |
|
154 College St Middletown CT 06457-3201 | |
| (860) 347-8894 | |
| (860) 346-2405 |
| Full Name | College Street Counseling Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 154 College St, Middletown, Connecticut |
| Authorized Official Name and Position | Phillip Sylvester (PARTNER) |
| Authorized Official Contact | 8603478894 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| College Street Counseling Center Llc 154 College St Middletown CT 06457-3201 Ph: (860) 347-8894 | College Street Counseling Center Llc 154 College St Middletown CT 06457-3201 Ph: (860) 347-8894 |
| NPI Number | 1093089948 |
|---|---|
| Provider Enumeration Date | 02/23/2012 |
| Last Update Date | 02/23/2012 |
| Medicare PECOS PAC ID | 7012179641 |
|---|---|
| Medicare Enrollment ID | O20120427000166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093089948 | NPI | - | NPPES |
| Provider Name | Kathleen S Watanabe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518079730 PECOS PAC ID: 0042486813 Enrollment ID: I20111228000296 |
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