| Community Counseling Center Of Central Ct Inc | |
|
53 Muir Ave Bristol CT 06010-7215 | |
| (860) 582-7904 | |
| (860) 582-4350 |
| Full Name | Community Counseling Center Of Central Ct Inc |
|---|---|
| Speciality | Counselor |
| Location | 53 Muir Ave, Bristol, Connecticut |
| Authorized Official Name and Position | Warren Corson (EXECUTIVE & CLINICAL DIRECTOR) |
| Authorized Official Contact | 8605827904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Counseling Center Of Central Ct Inc 53 Muir Ave Bristol CT 06010-7215 Ph: (860) 582-7904 | Community Counseling Center Of Central Ct Inc 53 Muir Ave Bristol CT 06010-7215 Ph: (860) 582-7904 |
| NPI Number | 1760541510 |
|---|---|
| Provider Enumeration Date | 12/07/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8820436892 |
|---|---|
| Medicare Enrollment ID | O20240410000515 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760541510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 001465 (Connecticut) | Primary |
| Provider Name | Lisa Marie Corson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255791406 PECOS PAC ID: 6002254075 Enrollment ID: I20240410000644 |
| Provider Name | Warren Corson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205097243 PECOS PAC ID: 9335587641 Enrollment ID: I20240423001654 |
| Provider Name | Brittany Hill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376281048 PECOS PAC ID: 4385085315 Enrollment ID: I20240508002564 |
| Provider Name | Amy Lisa Guyette |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669019337 PECOS PAC ID: 4385187764 Enrollment ID: I20240614000588 |
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