| Trellis Counseling And Wellness Llc | |
|
38 Patula Ct Southington CT 06489-1816 | |
| (203) 508-0644 | |
| Not Available |
| Full Name | Trellis Counseling And Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 38 Patula Ct, Southington, Connecticut |
| Authorized Official Name and Position | Theresa Marie Chawner (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2035080644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trellis Counseling And Wellness Llc 38 Patula Ct Southington CT 06489-1816 Ph: (203) 508-0644 | Trellis Counseling And Wellness Llc 38 Patula Ct Southington CT 06489-1816 Ph: (203) 508-0644 |
| NPI Number | 1265030910 |
|---|---|
| Provider Enumeration Date | 10/14/2020 |
| Last Update Date | 10/14/2020 |
| Certification Date | 10/14/2020 |
| Medicare PECOS PAC ID | 3971919697 |
|---|---|
| Medicare Enrollment ID | O20210304000633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265030910 | NPI | - | NPPES |
| 008084862 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Theresa Marie Chawner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548446925 PECOS PAC ID: 5799191417 Enrollment ID: I20210304000764 |
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