| Matthew Clark, | |
|
360 Bloomfield Ave, Ste 301, Windsor, CT 06095-2700 | |
| (860) 607-3235 | |
| (860) 607-3201 |
| Full Name | Matthew Clark |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 12 Years |
| Location | 360 Bloomfield Ave, Windsor, Connecticut |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417353996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 002674 (Connecticut) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Clark Counseling Services, Llc | 3971940032 | 2 |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220512000081 |
| Entity Name | Clark Counseling Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801332812 PECOS PAC ID: 3971940032 Enrollment ID: O20240325002430 |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew Clark, 360 Bloomfield Ave, Ste 301, Windsor, CT 06095-2700 Ph: (860) 607-3235 | Matthew Clark, 360 Bloomfield Ave, Ste 301, Windsor, CT 06095-2700 Ph: (860) 607-3235 |
Destiny Grant, Counselor Medicare: Not Enrolled in Medicare Practice Location: 995 Day Hill Rd, Windsor, CT 06095 Phone: 860-731-5522 Fax: 860-731-5536 | |
Joyce A Erickson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1343 Hillside Cir, Windsor, CT 06095 Phone: 860-707-9438 | |
Nardine Staroverov, Counselor Medicare: Not Enrolled in Medicare Practice Location: 32 Maple Ave Ste C, Windsor, CT 06095 Phone: 860-593-4908 | |
Valerie Barrett-noel, Counselor Medicare: May Accept Medicare Assignments Practice Location: 600 W Wolcott Ave, Windsor, CT 06095 Phone: 860-794-0652 | |
Antonette Bailey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 995 Day Hill Rd, Windsor, CT 06095 Phone: 860-731-5522 Fax: 860-731-5536 | |
Mrs. Rosanna Z Wilson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Kellogg St, Windsor, CT 06095 Phone: 860-219-1029 | |
Mr. Derek James Wilson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 360 Bloomfield Ave Ste 301, Windsor, CT 06095 Phone: 860-471-3819 |