| Coopersmith Counseling Center Llc | |
|
720 Hopmeadow St Ste 3 Simsbury CT 06070-2224 | |
| (203) 525-9024 | |
| Not Available |
| Full Name | Coopersmith Counseling Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 720 Hopmeadow St Ste 3, Simsbury, Connecticut |
| Authorized Official Name and Position | Jake Coopersmith (OWNER) |
| Authorized Official Contact | 2035259024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coopersmith Counseling Center Llc 720 Hopmeadow St Ste 3 Simsbury CT 06070-2224 Ph: (203) 525-9024 | Coopersmith Counseling Center Llc 720 Hopmeadow St Ste 3 Simsbury CT 06070-2224 Ph: (203) 525-9024 |
| NPI Number | 1700658325 |
|---|---|
| Provider Enumeration Date | 10/26/2023 |
| Last Update Date | 09/30/2024 |
| Certification Date | 09/30/2024 |
| Medicare PECOS PAC ID | 8820520182 |
|---|---|
| Medicare Enrollment ID | O20241011002963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700658325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jake Coopersmith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922681972 PECOS PAC ID: 3274065537 Enrollment ID: I20241011003357 |
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