| Courage To Be Llc | |
|
34 Jerome Ave Ste 116 Bloomfield CT 06002-2463 | |
| (860) 245-1027 | |
| Not Available |
| Full Name | Courage To Be Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 34 Jerome Ave Ste 116, Bloomfield, Connecticut |
| Authorized Official Name and Position | Yanique J Grant (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8602451027 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Courage To Be Llc 78 Montowese St Hartford CT 06114-3041 Ph: (860) 245-1027 | Courage To Be Llc 34 Jerome Ave Ste 116 Bloomfield CT 06002-2463 Ph: (860) 245-1027 |
| NPI Number | 1629635412 |
|---|---|
| Provider Enumeration Date | 05/28/2019 |
| Last Update Date | 05/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629635412 | NPI | - | NPPES |
| 1649638735 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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