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Organization
MIND MANAGEMENT SERVICES INC
Active
Organization
MIND MANAGEMENT SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE MARIE PAGE LCSW (CLINICAL SOCIAL WORKER / VICE PRESI)
(860) 889-4944
Entity
Organization
Contact information
Practice address
20 CENTRAL AVE, NORWICH, CT 06360-4753
(860) 889-4944
(860) 889-4944
Mailing address
20 CENTRAL AVE, NORWICH, CT 06360-4753
(860) 889-4944
(860) 889-4944
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
1041C0700X
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004254976
—
CT
01
—
140003950CT01
ANTHEM BC/BS
CT
Enumeration date
08/27/2007
Last updated
04/30/2013
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