| Southeastern Council On Alcoholism And Drug Dependence Inc | |
|
37 Camp Mooween Road Lebanon CT 06249 | |
| (860) 889-1717 | |
| (860) 886-2361 |
| Full Name | Southeastern Council On Alcoholism And Drug Dependence Inc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 37 Camp Mooween Road, Lebanon, Connecticut |
| Authorized Official Name and Position | Stacey Lynn Lawton (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8605793616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Council On Alcoholism And Drug Dependence Inc 1 Montauk Ave Ste 301 New London CT 06320-4967 Ph: (860) 447-1717 | Southeastern Council On Alcoholism And Drug Dependence Inc 37 Camp Mooween Road Lebanon CT 06249 Ph: (860) 889-1717 |
| NPI Number | 1003960022 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 10/07/2025 |
| Certification Date | 10/07/2025 |
| Medicare PECOS PAC ID | 0941349591 |
|---|---|
| Medicare Enrollment ID | O20091120000345 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003960022 | NPI | - | NPPES |
| 004144606 | Medicaid | CT | |
| 175904 | Other | CT | MAGELLAN |
| 008004220 | Medicaid | CT | |
| 149925 | Other | CT | HEALTH NET |
| 008110668 | Medicaid | CT | |
| 008133549 | Medicaid | CT | |
| 008132356 | Medicaid | CT | |
| 008109801 | Medicaid | CT | |
| 008110670 | Medicaid | CT | |
| 008075943 | Medicaid | CT | |
| 004042073 | Medicaid | CT |
| Provider Name | Lawrence J Peacock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902064173 PECOS PAC ID: 2466601414 Enrollment ID: I20130724000234 |
| Provider Name | Steven Fitch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700301710 PECOS PAC ID: 7315212289 Enrollment ID: I20171003003925 |
Coreworks, Counseling For Couples And Individuals Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 424 Deepwood Dr, Lebanon, CT 06249 Phone: 860-468-5353 |