| Compassionate Counseling And Culinary Arts Therapy Llc | |
|
15 Cassway Rd Woodbridge CT 06525-1214 | |
| (516) 528-3831 | |
| Not Available |
| Full Name | Compassionate Counseling And Culinary Arts Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15 Cassway Rd, Woodbridge, Connecticut |
| Authorized Official Name and Position | Stephanie Audra Jacobson (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5165283831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compassionate Counseling And Culinary Arts Therapy Llc 15 Cassway Rd Woodbridge CT 06525-1214 Ph: (516) 528-3831 | Compassionate Counseling And Culinary Arts Therapy Llc 15 Cassway Rd Woodbridge CT 06525-1214 Ph: (516) 528-3831 |
| NPI Number | 1790425387 |
|---|---|
| Provider Enumeration Date | 03/31/2022 |
| Last Update Date | 10/31/2022 |
| Certification Date | 10/31/2022 |
| Medicare PECOS PAC ID | 3779961578 |
|---|---|
| Medicare Enrollment ID | O20220607002644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790425387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Stephanie A Jacobson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558546093 PECOS PAC ID: 6103204904 Enrollment ID: I20220607002824 |
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