| Kerith Brook Counseling, LLC | |
|
9 Cody Street West Hartford CT 06110 | |
| (860) 288-7017 | |
| (860) 288-7017 |
| Full Name | Kerith Brook Counseling, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 9 Cody Street, West Hartford, Connecticut |
| Authorized Official Name and Position | Peta Lawson (CLINICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 8602887017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kerith Brook Counseling, LLC 9 Cody Street West Hartford CT 06110 Ph: (860) 288-7017 | Kerith Brook Counseling, LLC 9 Cody Street West Hartford CT 06110 Ph: (860) 288-7017 |
| NPI Number | 1417711847 |
|---|---|
| Provider Enumeration Date | 02/07/2024 |
| Last Update Date | 03/05/2025 |
| Certification Date | 03/04/2025 |
| Medicare PECOS PAC ID | 8628419793 |
|---|---|
| Medicare Enrollment ID | O20240508000256 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417711847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Peta Lawson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033870365 PECOS PAC ID: 4183060619 Enrollment ID: I20240307000199 |
| Provider Name | Eric Stillman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942793344 PECOS PAC ID: 4587004692 Enrollment ID: I20240506003134 |
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