| Courage To Grow, Llc | |
|
162 B East Main Street Courage To Grow, Llc Clinton CT 06413 | |
| (860) 664-3592 | |
| (860) 664-3906 |
| Full Name | Courage To Grow, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 162 B East Main Street, Clinton, Connecticut |
| Authorized Official Name and Position | Susan J Isaac (OWNER) |
| Authorized Official Contact | 8606643592 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Courage To Grow, Llc 162 B East Main Street Clinton CT 06413 Ph: (860) 664-3592 | Courage To Grow, Llc 162 B East Main Street Courage To Grow, Llc Clinton CT 06413 Ph: (860) 664-3592 |
| NPI Number | 1437437431 |
|---|---|
| Provider Enumeration Date | 07/26/2011 |
| Last Update Date | 07/26/2011 |
| Medicare PECOS PAC ID | 4284802877 |
|---|---|
| Medicare Enrollment ID | O20110726000824 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437437431 | NPI | - | NPPES |
| 008002029 | Medicaid | CT | |
| 9560177 | Other | CT | AETNA |
| P4074057 | Other | CT | OXFORD |
| 0062-0087436 | Other | CT | UNITED HEALTHCARE SERVICES, INC. |
| 469787 | Other | CT | MHN |
| 140005911CT01 | Other | CT | ANTHEM |
| 9560177 | Other | CT | AETNA PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 005911 (Connecticut) | Primary |
| Provider Name | Susan J Isaac |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013182518 PECOS PAC ID: 9335317932 Enrollment ID: I20110728000224 |
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