| Man-up Counseling And Mentoring Centers Llc | |
|
660 Newfield St Middletown CT 06457-1897 | |
| (860) 834-7486 | |
| Not Available |
| Full Name | Man-up Counseling And Mentoring Centers Llc |
|---|---|
| Speciality | Counselor |
| Location | 660 Newfield St, Middletown, Connecticut |
| Authorized Official Name and Position | Edwin Dejesus (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 8607163081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Man-up Counseling And Mentoring Centers Llc 31 Peyton Place Middletown CT 06457 Ph: (860) 834-7486 | Man-up Counseling And Mentoring Centers Llc 660 Newfield St Middletown CT 06457-1897 Ph: (860) 834-7486 |
| NPI Number | 1932743879 |
|---|---|
| Provider Enumeration Date | 11/04/2019 |
| Last Update Date | 01/31/2025 |
| Certification Date | 01/31/2025 |
| Medicare PECOS PAC ID | 7113447491 |
|---|---|
| Medicare Enrollment ID | O20250218001875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932743879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Edwin Dejesus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801439427 PECOS PAC ID: 8022538305 Enrollment ID: I20250218001943 |
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