# LEO CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** leo clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285453811
- **Authorized official:** DR. CARLOS MARRERO (CEO)
- **Authorized official phone:** (860) 249-0975

## Contact information

- **Practice address:** 602 NEW BRITAIN AVE, HARTFORD, CT 06106-4033
- **Practice address phone:** (860) 249-0975
- **Mailing address:** 602 NEW BRITAIN AVE, HARTFORD, CT 06106-4033
- **Mailing address phone:** (860) 249-0975

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/09/2024
- **Last updated:** 10/09/2024