| Small Victories Wellness Services, Pllc | |
|
360 Main St Ste 2d Middletown CT 06457-3375 | |
| (860) 248-6041 | |
| Not Available |
| Full Name | Small Victories Wellness Services, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 360 Main St Ste 2d, Middletown, Connecticut |
| Authorized Official Name and Position | Carrissa Phipps (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 8607402041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Small Victories Wellness Services, Pllc 360 Main St Ste 2d Middletown CT 06457-3375 Ph: (860) 248-6041 | Small Victories Wellness Services, Pllc 360 Main St Ste 2d Middletown CT 06457-3375 Ph: (860) 248-6041 |
| NPI Number | 1861911455 |
|---|---|
| Provider Enumeration Date | 09/14/2017 |
| Last Update Date | 01/13/2022 |
| Certification Date | 01/13/2022 |
| Medicare PECOS PAC ID | 7618236761 |
|---|---|
| Medicare Enrollment ID | O20180117001358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861911455 | NPI | - | NPPES |
| Provider Name | Carrissa Phillippe Phipps |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932628963 PECOS PAC ID: 9234498387 Enrollment ID: I20180117001524 |
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