Organization Name: | NORTH CENTRAL CONNECTICUT PSYCHOTHERAPY |
NPI Number: | 1053674127 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY CATHRYN ALIENGENA (LICENSED PROFESSIONAL COUNSELOR) |
Mailing Address: | 230b Mountain Rd Suffield |
State: | CT US |
Postal Code: | 060782094 |
Phone Number: | 4134781764 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2012 |
NPI Last Update Date: | 06/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 001395 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |