Positive Change Therapy, Pllc | |
422 Highland Ave Ste 5 Cheshire CT 06410-2526 | |
(203) 651-9255 | |
Not Available |
Full Name | Positive Change Therapy, Pllc |
---|---|
Speciality | Social Worker |
Location | 422 Highland Ave Ste 5, Cheshire, Connecticut |
Authorized Official Name and Position | Jessica Byers (CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 2036519255 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Positive Change Therapy, Pllc 345 Payne Dr Cheshire CT 06410-1752 Ph: (860) 651-9255 | Positive Change Therapy, Pllc 422 Highland Ave Ste 5 Cheshire CT 06410-2526 Ph: (203) 651-9255 |
NPI Number | 1154965150 |
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Provider Enumeration Date | 11/01/2019 |
Last Update Date | 11/01/2019 |
Medicare PECOS PAC ID | 0446683361 |
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Medicare Enrollment ID | O20191209000166 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154965150 | NPI | - | NPPES |
004025193 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Jessica J Byers |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1639440969 PECOS PAC ID: 0749591386 Enrollment ID: I20150623001727 |
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