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Organization
ANDOVER, HEBRON, MARLBOROUGH YOUTH & FAMILY SERVICES, INC.
Active
Organization
ANDOVER, HEBRON, MARLBOROUGH YOUTH & FAMILY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH KATE EKVALL (CLINICAL DEPARTMENT)
(860) 228-9488
Entity
Organization
Contact information
Practice address
25 PENDLETON DR, HEBRON, CT 06248-1525
(860) 228-9488
(860) 228-1213
Mailing address
25 PENDLETON DR, HEBRON, CT 06248-1525
(860) 228-9488
(860) 228-1213
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004258192
—
CT
05
—
008014267
—
CT
05
—
008064980
—
CT
Enumeration date
07/14/2008
Last updated
07/26/2016
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