| Sound Mind, L.l.c. | |
|
1115 Main St Suite 702 Bridgeport CT 06604-4406 | |
| (203) 243-5159 | |
| Not Available |
| Full Name | Sound Mind, L.l.c. |
|---|---|
| Speciality | Social Worker |
| Location | 1115 Main St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Deborah Ruth Alter (OWNER) |
| Authorized Official Contact | 2032435159 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sound Mind, L.l.c. 1115 Main St Suite 702 Bridgeport CT 06604-4406 Ph: (203) 243-5159 | Sound Mind, L.l.c. 1115 Main St Suite 702 Bridgeport CT 06604-4406 Ph: (203) 243-5159 |
| NPI Number | 1972721520 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1355411034 |
|---|---|
| Medicare Enrollment ID | O20080606000573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972721520 | NPI | - | NPPES |
| 1972721512 | Other | CT | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 003591 (Connecticut) | Primary |
| Provider Name | Deborah R Alter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972721512 PECOS PAC ID: 7719057496 Enrollment ID: I20080606000567 |
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