| Southwindsorpsychotherapy | |
|
1169 Ellington Rd South Windsor CT 06074-3515 | |
| (860) 978-5916 | |
| Not Available |
| Full Name | Southwindsorpsychotherapy |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1169 Ellington Rd, South Windsor, Connecticut |
| Authorized Official Name and Position | Timothy J Jeski (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8603242840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwindsorpsychotherapy 512 Main St Newington CT 06111-2413 Ph: (860) 978-5916 | Southwindsorpsychotherapy 1169 Ellington Rd South Windsor CT 06074-3515 Ph: (860) 978-5916 |
| NPI Number | 1275279697 |
|---|---|
| Provider Enumeration Date | 05/09/2022 |
| Last Update Date | 05/09/2022 |
| Certification Date | 04/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275279697 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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