| Seagull Counseling & Therapy Llc | |
|
35 Nutmeg Lane Fairfield CT 06824 | |
| (203) 993-5831 | |
| (203) 259-3338 |
| Full Name | Seagull Counseling & Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 35 Nutmeg Lane, Fairfield, Connecticut |
| Authorized Official Name and Position | Susan L Henry (OWNER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2032588627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seagull Counseling & Therapy Llc 35 Nutmeg Ln Fairfield CT 06824-3909 Ph: (203) 993-5831 | Seagull Counseling & Therapy Llc 35 Nutmeg Lane Fairfield CT 06824 Ph: (203) 993-5831 |
| NPI Number | 1831652064 |
|---|---|
| Provider Enumeration Date | 04/14/2019 |
| Last Update Date | 04/14/2019 |
| Medicare PECOS PAC ID | 7517292477 |
|---|---|
| Medicare Enrollment ID | O20190715001777 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831652064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susan Lipman Henry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730642935 PECOS PAC ID: 9335474295 Enrollment ID: I20190715001966 |
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