| Melissa Gobin, Licsw, Lcsw Llc | |
|
64 Gaumond Rd North Grosvenordale CT 06255-2009 | |
| (860) 377-8995 | |
| Not Available |
| Full Name | Melissa Gobin, Licsw, Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 64 Gaumond Rd, North Grosvenordale, Connecticut |
| Authorized Official Name and Position | Melissa Gobin - Borski (OWNER) |
| Authorized Official Contact | 8603778995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa Gobin, Licsw, Lcsw Llc 64 Gaumond Rd North Grosvenordale CT 06255-2009 Ph: (860) 377-8995 | Melissa Gobin, Licsw, Lcsw Llc 64 Gaumond Rd North Grosvenordale CT 06255-2009 Ph: (860) 377-8995 |
| NPI Number | 1396487674 |
|---|---|
| Provider Enumeration Date | 04/08/2022 |
| Last Update Date | 09/04/2024 |
| Certification Date | 09/04/2024 |
| Medicare PECOS PAC ID | 1355728189 |
|---|---|
| Medicare Enrollment ID | O20220518000107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396487674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Melissa Ann Gobin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275733594 PECOS PAC ID: 4284779281 Enrollment ID: I20100302000437 |
N/a Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 185 Fabyan Rd, North Grosvenordale, CT 06255 Phone: 860-315-0565 Fax: 860-315-0565 |