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Organization
CONNECTICUT ADDICTION MEDICINE, LLC
Active
Organization
CONNECTICUT ADDICTION MEDICINE, LLC
Active
Other names
Connecticut Addiction Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY INGOLD OFFICE MANAGER (OFFICE MANAGER)
(860) 969-1101
Entity
Organization
Contact information
Practice address
546 CROMWELL AVE, SUITE 101, ROCKY HILL, CT 06067-1800
(860) 757-3874
(860) 757-3875
Mailing address
546 CROMWELL AVE, SUITE 101, ROCKY HILL, CT 06067-1800
(860) 757-3874
(860) 757-3875
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
CLPOL0509
CT
363LA2200X
Adult Health Nurse Practitioner
—
CT
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
09/13/2013
Last updated
04/19/2017
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