| Michelle Pellin MS Ma LPC LLC | |
|
352 Main St Durham CT 06422-1645 | |
| (860) 805-7819 | |
| Not Available |
| Full Name | Michelle Pellin MS Ma LPC LLC |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 352 Main St, Durham, Connecticut |
| Authorized Official Name and Position | Michelle Pellin (OWNER) |
| Authorized Official Contact | 8608057819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Pellin MS Ma LPC LLC 32 Buttonhook Dr Portland CT 06480-1375 Ph: (860) 805-7819 | Michelle Pellin MS Ma LPC LLC 352 Main St Durham CT 06422-1645 Ph: (860) 805-7819 |
| NPI Number | 1598232936 |
|---|---|
| Provider Enumeration Date | 10/24/2018 |
| Last Update Date | 10/24/2018 |
| Medicare PECOS PAC ID | 2769988252 |
|---|---|
| Medicare Enrollment ID | O20251002004802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598232936 | NPI | - | NPPES |
| 008059952 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Primary |
| Provider Name | Michelle M Pellin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649653205 PECOS PAC ID: 6305342890 Enrollment ID: I20251002004861 |
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