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Organization
SAINT FRANCIS BEHAVIORAL HEALTH GROUP, P.C.
Active
Organization
SAINT FRANCIS BEHAVIORAL HEALTH GROUP, P.C.
Active
Other names
PATH OUTPATIENT SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA KIDA (BUSINESS MANAGER)
(860) 714-9333
Entity
Organization
Contact information
Practice address
675 TOWER AVENUE, SUITE 301, HARTFORD, CT 06112-1260
(860) 714-2750
(860) 714-8591
Mailing address
675 TOWER AVE, SUITE 301, HARTFORD, CT 06112-1273
(860) 714-2750
(860) 714-8591
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
CT
103TC0700X
Clinical Psychologist
—
CT
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004197788
—
CT
05
—
004210069
—
CT
05
—
004210481
—
CT
05
—
004245909
—
CT
05
—
004255891
—
CT
05
—
004255966
—
CT
05
—
004256013
—
CT
01
—
50PATHPCICT01
ANTHEM BC/BS GROUP #
CT
Enumeration date
06/03/2006
Last updated
01/28/2014
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