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270 Farmington Ave Ste 346 Farmington CT 06032-1909 | |
| (860) 995-6838 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 270 Farmington Ave Ste 346, Farmington, Connecticut |
| Authorized Official Name and Position | Joshua Ian Cohen (OWNER) |
| Authorized Official Contact | 8609956838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
16 Devonshire Dr South Windsor CT 06074-2263 Ph: () - | 270 Farmington Ave Ste 346 Farmington CT 06032-1909 Ph: (860) 995-6838 |
| NPI Number | 1417387150 |
|---|---|
| Provider Enumeration Date | 11/15/2013 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Medicare PECOS PAC ID | 2264972090 |
|---|---|
| Medicare Enrollment ID | O20240909000510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417387150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 1606 (Connecticut) | Primary |
| Provider Name | Austin J Heffernan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1861188757 PECOS PAC ID: 7416497250 Enrollment ID: I20240909000589 |
| Provider Name | Linda Wall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568192565 PECOS PAC ID: 2567994528 Enrollment ID: I20241015002756 |
| Provider Name | Laura Mutrie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659522720 PECOS PAC ID: 3678005642 Enrollment ID: I20241015003121 |
| Provider Name | Joshua Cohen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1053690842 PECOS PAC ID: 7911394713 Enrollment ID: I20241031002190 |
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