Change Counseling, Llc | |
750r Main St Willimantic CT 06226-2504 | |
(860) 833-2657 | |
Not Available |
Full Name | Change Counseling, Llc |
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Speciality | Social Worker |
Location | 750r Main St, Willimantic, Connecticut |
Authorized Official Name and Position | Madelyn Briggs (OWNER) |
Authorized Official Contact | 8608332657 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Change Counseling, Llc 261 Church St Willimantic CT 06226-2625 Ph: (860) 833-2657 | Change Counseling, Llc 750r Main St Willimantic CT 06226-2504 Ph: (860) 833-2657 |
NPI Number | 1780141465 |
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Provider Enumeration Date | 02/28/2019 |
Last Update Date | 02/28/2019 |
Medicare PECOS PAC ID | 9234564956 |
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Medicare Enrollment ID | O20200127000687 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780141465 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Gary A Palardy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518397983 PECOS PAC ID: 5991933095 Enrollment ID: I20140117001200 |
Provider Name | Madelyn Rosemary Straub |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1831567023 PECOS PAC ID: 3779855317 Enrollment ID: I20170817000383 |
Provider Name | Jessica Baine |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1164890232 PECOS PAC ID: 6507104247 Enrollment ID: I20190305002284 |
Provider Name | Rachel Hence |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1720012099 PECOS PAC ID: 9335489616 Enrollment ID: I20190325000114 |
Provider Name | Melanie Grieco |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1104239581 PECOS PAC ID: 7517373608 Enrollment ID: I20210316001070 |
Provider Name | Judith Smith |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1063755767 PECOS PAC ID: 8628513785 Enrollment ID: I20240712001675 |
Provider Name | Cheryl L Jacques |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1700939998 PECOS PAC ID: 6406392398 Enrollment ID: I20240727000398 |
Provider Name | Summer Collins |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1235972019 PECOS PAC ID: 4385183888 Enrollment ID: I20241219001695 |
Provider Name | Victoria Sousa |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1104487586 PECOS PAC ID: 7517494628 Enrollment ID: I20241231000100 |
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