| Kmg Therapy And Consulting Llc | |
|
481 Gold Star Hwy Suite 301 Groton CT 06340-6702 | |
| (860) 917-1779 | |
| (860) 447-8122 |
| Full Name | Kmg Therapy And Consulting Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 481 Gold Star Hwy, Groton, Connecticut |
| Authorized Official Name and Position | Maria M Gallagher (MEMBER) |
| Authorized Official Contact | 8609171779 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kmg Therapy And Consulting Llc 1075 E Lake Rd Oakdale CT 06370-1818 Ph: (860) 917-1779 | Kmg Therapy And Consulting Llc 481 Gold Star Hwy Suite 301 Groton CT 06340-6702 Ph: (860) 917-1779 |
| NPI Number | 1760856181 |
|---|---|
| Provider Enumeration Date | 11/23/2015 |
| Last Update Date | 11/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760856181 | NPI | - | NPPES |
| 0006568 | Other | CT | VALUEOPTIONS CT BHP |
| 008056500 | Medicaid | CT | |
| D300184136 | Other | CT | MEDICARE PTAN |
| 13515495 | Other | CT | COUNCIL FOR AFFORDABLE QUALITY HEALTH (CAQH) |
| 544181 | Other | CT | MANAGED HEALTH NETWORK (MHN) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 8823 (Connecticut) | Primary |
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