| Laurel Health Services, Llc | |
|
295 Washington Ave Suite 9 Hamden CT 06518-3025 | |
| (203) 287-8227 | |
| (203) 287-9502 |
| Full Name | Laurel Health Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 295 Washington Ave, Hamden, Connecticut |
| Authorized Official Name and Position | Jeffrey Warren Summerville (PARTNER) |
| Authorized Official Contact | 2032878227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laurel Health Services, Llc 295 Washington Ave Suite 9 Hamden CT 06518-3025 Ph: (203) 287-8227 | Laurel Health Services, Llc 295 Washington Ave Suite 9 Hamden CT 06518-3025 Ph: (203) 287-8227 |
| NPI Number | 1891716627 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 11/28/2011 |
| Medicare PECOS PAC ID | 4284639261 |
|---|---|
| Medicare Enrollment ID | O20060926000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891716627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 589570 (Connecticut) | Primary |
| Provider Name | Leslie P Pollack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104847201 PECOS PAC ID: 3173528155 Enrollment ID: I20070621000090 |
| Provider Name | Robert M Koenig |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528078441 PECOS PAC ID: 7810992898 Enrollment ID: I20120319000252 |
| Provider Name | Jeffrey Warren Summerville |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013926708 PECOS PAC ID: 8729083704 Enrollment ID: I20181206002854 |
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