| Personal Growth Concepts, Inc. | |
|
1825 Barnum Ave Suite 304 Stratford CT 06614-5333 | |
| (203) 375-5782 | |
| (203) 375-3048 |
| Full Name | Personal Growth Concepts, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 1825 Barnum Ave, Stratford, Connecticut |
| Authorized Official Name and Position | John A Pacheco (PRESIDENT/DIRECTOR) |
| Authorized Official Contact | 2033755782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Personal Growth Concepts, Inc. 2505 Main St Ste 231 Suite 304 Stratford CT 06615-5839 Ph: (203) 375-5782 | Personal Growth Concepts, Inc. 1825 Barnum Ave Suite 304 Stratford CT 06614-5333 Ph: (203) 375-5782 |
| NPI Number | 1104850353 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 01/27/2017 |
| Medicare PECOS PAC ID | 9234224395 |
|---|---|
| Medicare Enrollment ID | O20071004000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104850353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | John A Pacheco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073531133 PECOS PAC ID: 0840385902 Enrollment ID: I20111206000603 |
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