| The Awareness Center Llc | |
|
796 Highland Ave 2nd Floor Waterbury CT 06708-4710 | |
| (203) 757-0151 | |
| (203) 757-0153 |
| Full Name | The Awareness Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 796 Highland Ave, Waterbury, Connecticut |
| Authorized Official Name and Position | Michael S Graham (CEO) |
| Authorized Official Contact | 2037570151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Awareness Center Llc 796 Highland Ave 2nd Floor Waterbury CT 06708 Ph: (203) 757-0151 | The Awareness Center Llc 796 Highland Ave 2nd Floor Waterbury CT 06708-4710 Ph: (203) 757-0151 |
| NPI Number | 1265736276 |
|---|---|
| Provider Enumeration Date | 01/05/2011 |
| Last Update Date | 06/17/2013 |
| Medicare PECOS PAC ID | 8921284738 |
|---|---|
| Medicare Enrollment ID | O20110512000038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265736276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 006958 (Connecticut) | Secondary |
| 251S00000X | Community/behavioral Health | 006958 (Connecticut) | Primary |
| Provider Name | Michael Sean Graham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861632507 PECOS PAC ID: 6406906213 Enrollment ID: I20090616000444 |
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