| Mr Gerald Wagner Jr, LADC | |
|
21 Montauk Ave, New London, CT 06320-4906 | |
| (860) 271-4715 | |
| (860) 271-4797 |
| Full Name | Mr Gerald Wagner Jr |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 21 Montauk Ave, New London, Connecticut |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962759084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 000326 (Connecticut) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Gerald Wagner Jr, LADC Po Box 390, New London, CT 06320-0390 Ph: (860) 271-4715 | Mr Gerald Wagner Jr, LADC 21 Montauk Ave, New London, CT 06320-4906 Ph: (860) 271-4715 |
Nichole Burns, Counselor Medicare: Medicare Enrolled Practice Location: 21 Montauk Avene, New London, CT 06320 Phone: 860-271-4715 Fax: 860-271-4797 | |
Theresa M. Bonanomi, Counselor Medicare: Accepting Medicare Assignments Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-444-5141 | |
Bethany Gallant, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 21 Montauk Ave, New London, CT 06320 Phone: 860-443-0530 Fax: 860-443-0536 | |
Lindsay Warner, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 Vauxhall St, New London, CT 06320 Phone: 860-437-4550 Fax: 860-661-4262 | |
Marie Salvemini, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Shaws Cv, New London, CT 06320 Phone: 860-447-8304 Fax: 860-443-8720 | |
Katherine Cichon, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 State St, Suite 307, New London, CT 06320 Phone: 860-941-9380 | |
Madilynn Jane Delach, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 Vauxhall St, New London, CT 06320 Phone: 860-437-4550 |