| Support: You | |
|
304 Federal Rd Ste 312 Brookfield CT 06804-2419 | |
| (203) 826-4262 | |
| Not Available |
| Full Name | Support: You |
|---|---|
| Speciality | Clinic/Center |
| Location | 304 Federal Rd Ste 312, Brookfield, Connecticut |
| Authorized Official Name and Position | Jessica Sousa Santos (OWNER) |
| Authorized Official Contact | 2038264262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Support: You 304 Federal Rd Ste 312 Brookfield CT 06804-2419 Ph: (203) 826-4262 | Support: You 304 Federal Rd Ste 312 Brookfield CT 06804-2419 Ph: (203) 826-4262 |
| NPI Number | 1821737446 |
|---|---|
| Provider Enumeration Date | 06/01/2022 |
| Last Update Date | 04/27/2023 |
| Certification Date | 04/26/2023 |
| Medicare PECOS PAC ID | 6204205909 |
|---|---|
| Medicare Enrollment ID | O20221219001753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821737446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Jessica M Sousa Santos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326534918 PECOS PAC ID: 5092069179 Enrollment ID: I20181107003064 |
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