| Community Guidance Clinic For Central Connecticut, Inc | |
|
384 Pratt St Meriden CT 06450-8627 | |
| (203) 235-5767 | |
| (203) 238-2010 |
| Full Name | Community Guidance Clinic For Central Connecticut, Inc |
|---|---|
| Speciality | Counselor |
| Location | 384 Pratt St, Meriden, Connecticut |
| Authorized Official Name and Position | Wanda Ivelisse Rodriguez (BILLING ADMINISTRATOR) |
| Authorized Official Contact | 2032355767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Guidance Clinic For Central Connecticut, Inc 384 Pratt St Meriden CT 06450-8627 Ph: (203) 235-5767 | Community Guidance Clinic For Central Connecticut, Inc 384 Pratt St Meriden CT 06450-8627 Ph: (203) 235-5767 |
| NPI Number | 1851880546 |
|---|---|
| Provider Enumeration Date | 05/08/2018 |
| Last Update Date | 02/24/2025 |
| Certification Date | 02/24/2025 |
| Medicare PECOS PAC ID | 7315479631 |
|---|---|
| Medicare Enrollment ID | O20250312001190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851880546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Megan Clarke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760958870 PECOS PAC ID: 6507398823 Enrollment ID: I20241011001174 |
| Provider Name | Regina Marshall |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1457979593 PECOS PAC ID: 4082149349 Enrollment ID: I20241122001783 |
| Provider Name | Emily Blewitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295131043 PECOS PAC ID: 7416470943 Enrollment ID: I20250326000136 |
| Provider Name | Kristen Wagner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1164912325 PECOS PAC ID: 1557880143 Enrollment ID: I20250528000080 |
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