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Organization
WALTER VAN SAMBECK
Active
Organization
WALTER VAN SAMBECK
Active
Other names
Connecticut Center for Human Growth& Dev.
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER JOHANNES VAN SAMBECK (OWNER)
(860) 537-3977
Entity
Organization
Contact information
Practice address
244 S MAIN ST, COLCHESTER, CT 06415-1405
(860) 537-3977
Mailing address
244 S MAIN ST, COLCHESTER, CT 06415-1405
(860) 537-3977
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000493
CT
101YP2500X
Professional Counselor
Primary
000493
CT
103TP0016X
Prescribing (Medical) Psychologist
023879
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275632994
NPI
—
01
—
1437218823
NPI
—
Enumeration date
12/10/2007
Last updated
06/16/2008
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