| Spirit Clinic Llc | |
|
64 Wall St Ste 306 Norwalk CT 06850-3403 | |
| (347) 622-9524 | |
| Not Available |
| Full Name | Spirit Clinic Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 64 Wall St Ste 306, Norwalk, Connecticut |
| Authorized Official Name and Position | Cristal Sampson (OWNER, CLINICIAN) |
| Authorized Official Contact | 3476229524 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spirit Clinic Llc 64 Wall St Ste 306 Norwalk CT 06850-3403 Ph: () - | Spirit Clinic Llc 64 Wall St Ste 306 Norwalk CT 06850-3403 Ph: (347) 622-9524 |
| NPI Number | 1770122947 |
|---|---|
| Provider Enumeration Date | 01/05/2020 |
| Last Update Date | 01/05/2020 |
| Certification Date | 01/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770122947 | NPI | - | NPPES |
| 1942700430 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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