| Michael John Formica, LPC | |
|
616 Gold Star Hwy, Groton, CT 06340-6221 | |
| (860) 449-0200 | |
| (860) 449-1954 |
| Full Name | Michael John Formica |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 616 Gold Star Hwy, Groton, Connecticut |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174688311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 000869 (Connecticut) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Michael John Formica, LPC 32 Sea Crest Ave, Niantic, CT 06357-3808 Ph: (203) 912-7218 | Michael John Formica, LPC 616 Gold Star Hwy, Groton, CT 06340-6221 Ph: (860) 449-0200 |
Mary-katherine Louetta Peralez, LPC Counselor Medicare: Medicare Enrolled Practice Location: 915 Poquonnock Rd, Groton, CT 06340 Phone: 860-471-7896 | |
Dr. Lisa Marie Tonnessen, PHD Counselor Medicare: Medicare Enrolled Practice Location: 616 Goldstar Hgwy, Shoreline Counseling, Groton, CT 06340 Phone: 860-449-0200 Fax: 860-449-1954 | |
Ms. Susannah Jane Forte Stahr, MS, MFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 591 Poquonnock Rd, Groton, CT 06340 Phone: 860-449-8217 Fax: 860-449-8323 | |
Dr. F. Henry Doran, D.MIN, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 616 Gold Star Hwy, Groton, CT 06340 Phone: 860-449-0200 Fax: 860-449-1954 | |
Ms. Jessica M Gagnon, LCSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 428 Long Hill Rd Ste 201, Groton, CT 06340 Phone: 860-705-2840 | |
Rachel Marie Powell, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 611a Long Hill Rd, Groton, CT 06340 Phone: 860-405-8097 Fax: 860-572-4986 |