| Ec Thera-fit Group, Llc | |
|
900 Main St Oakville CT 06779-1999 | |
| (860) 856-3380 | |
| Not Available |
| Full Name | Ec Thera-fit Group, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 900 Main St, Oakville, Connecticut |
| Authorized Official Name and Position | Dwayne Clements (MANAGER) |
| Authorized Official Contact | 8608563380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ec Thera-fit Group, Llc 52 Spring Rd Wolcott CT 06716-1616 Ph: () - | Ec Thera-fit Group, Llc 900 Main St Oakville CT 06779-1999 Ph: (860) 856-3380 |
| NPI Number | 1265099667 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 05/22/2019 |
| Medicare PECOS PAC ID | 7810309820 |
|---|---|
| Medicare Enrollment ID | O20201216001811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265099667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nellie E Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679742282 PECOS PAC ID: 7416026927 Enrollment ID: I20080522000548 |
| Provider Name | Lemlem Egziabher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255592739 PECOS PAC ID: 7517030745 Enrollment ID: I20080722000406 |
| Provider Name | John Croffett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861618639 PECOS PAC ID: 6709827892 Enrollment ID: I20181004000662 |
| Provider Name | Keisha Clayton-fearon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891240776 PECOS PAC ID: 7517205446 Enrollment ID: I20190219000396 |
| Provider Name | Nicole Osborne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154983229 PECOS PAC ID: 7517391972 Enrollment ID: I20210211002539 |
| Provider Name | Barbara A Hatch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912667460 PECOS PAC ID: 9537554902 Enrollment ID: I20220322000658 |
| Provider Name | Evelyn C Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316379969 PECOS PAC ID: 1153767157 Enrollment ID: I20240313001341 |
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