| Townshend-lacock, Inc. | |
|
147 Durham Rd Madison CT 06443-2675 | |
| (203) 245-8732 | |
| (203) 457-9465 |
| Full Name | Townshend-lacock, Inc. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 147 Durham Rd, Madison, Connecticut |
| Authorized Official Name and Position | Darrell D. Lacock (PRESIDENT) |
| Authorized Official Contact | 2032458732 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Townshend-lacock, Inc. 1420 West St Guilford CT 06437-1075 Ph: (203) 245-8732 | Townshend-lacock, Inc. 147 Durham Rd Madison CT 06443-2675 Ph: (203) 245-8732 |
| NPI Number | 1306159405 |
|---|---|
| Provider Enumeration Date | 07/17/2010 |
| Last Update Date | 07/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306159405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 000940 (Connecticut) | Primary |
| 1041C0700X | Social Worker - Clinical | 001164 (Connecticut) | Secondary |
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