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Individual

IAN KOVAC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, LMHC, MT-BC

Contact information

Practice address
14 SYCAMORE WAY, BRANFORD, CT 06405-6551
(203) 483-2630
Mailing address
74 RIGGS ST, OXFORD, CT 06478-1208
(203) 305-1580

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
12552
MA
101YM0800X
Mental Health Counselor
Primary
6410
CT
225A00000X
Music Therapist
12607

Other

Enumeration date
06/02/2023
Last updated
06/02/2023
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