| Barbara J. Fasulo, Lcsw, Llc | |
|
2257 Silas Deane Hwy Rocky Hill CT 06067-2328 | |
| (860) 416-5288 | |
| Not Available |
| Full Name | Barbara J. Fasulo, Lcsw, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2257 Silas Deane Hwy, Rocky Hill, Connecticut |
| Authorized Official Name and Position | Barbara J. Fasulo (OWNER) |
| Authorized Official Contact | 8604165288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Barbara J. Fasulo, Lcsw, Llc 2257 Silas Deane Hwy Rocky Hill CT 06067-2328 Ph: (860) 416-5288 | Barbara J. Fasulo, Lcsw, Llc 2257 Silas Deane Hwy Rocky Hill CT 06067-2328 Ph: (860) 416-5288 |
| NPI Number | 1447916622 |
|---|---|
| Provider Enumeration Date | 11/12/2021 |
| Last Update Date | 11/14/2021 |
| Certification Date | 11/14/2021 |
| Medicare PECOS PAC ID | 9032509641 |
|---|---|
| Medicare Enrollment ID | O20211214000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447916622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Barbara J Fasulo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952883258 PECOS PAC ID: 0941690556 Enrollment ID: I20211214000052 |
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