| None | |
|
9 Ledyard Ave Bloomfield CT 06002-3353 | |
| (860) 478-5399 | |
| (860) 904-9197 |
| Full Name | None |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 9 Ledyard Ave, Bloomfield, Connecticut |
| Authorized Official Name and Position | Albert F. A. Young (OWNER) |
| Authorized Official Contact | 8604785399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 9 Ledyard Ave Bloomfield CT 06002-3353 Ph: (860) 478-5399 | None 9 Ledyard Ave Bloomfield CT 06002-3353 Ph: (860) 478-5399 |
| NPI Number | 1902906886 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 09/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902906886 | NPI | - | NPPES |
| 300000343CT09 | Other | CT | BLUECARE HEALTH PLAN |
| 2063285 | Other | CT | CIGNA BEHAVIORAL HEALTH |
| 300000343CT02 | Other | CT | BLUECARE HEALTH PLAN |
| 300000343CT11 | Other | CT | FEDERAL EMPLOYEE PLAN |
| 300000343CT10 | Other | CT | CENTURY 90 AND BLUECARD T |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 000343 (Connecticut) | Primary |
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