| Lisa Shoglow, Llc | |
| 
					64 Old Hyde Rd Weston CT 06883-1726  | |
| (203) 810-8348 | |
| Not Available | 
| Full Name | Lisa Shoglow, Llc | 
|---|---|
| Speciality | Marriage & Family Therapist | 
| Location | 64 Old Hyde Rd, Weston, Connecticut | 
| Authorized Official Name and Position | Grace Cullen (MEDICAL BILLING MANAGER) | 
| Authorized Official Contact | 2033685515 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lisa Shoglow, Llc 64 Old Hyde Rd Weston CT 06883-1726 Ph: (203) 810-8348  | Lisa Shoglow, Llc 64 Old Hyde Rd Weston CT 06883-1726 Ph: (203) 810-8348  | 
| NPI Number | 1366908550 | 
|---|---|
| Provider Enumeration Date | 02/13/2019 | 
| Last Update Date | 02/13/2019 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1366908550 | NPI | - | NPPES | 
| 004069985 | Medicaid | CT | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary | 
Ssp Aba Site Two Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 Briar Oak Dr, Weston, CT 06883 Phone: 516-353-4999  | |
Steven Blauner Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 83 Georgetown Rd, Weston, CT 06883 Phone: 914-263-7240  | |
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