Organization
ASHLEY MONCK LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY BRUCKENTHAL (SOCIAL WORKER)
(203) 302-9378
Entity
Organization
Contact information
Practice address
30 DEEPWOOD DR, BETHEL, CT 06801-1267
(203) 302-9378
Mailing address
54 DANBURY RD STE 337, RIDGEFIELD, CT 06877-4019
(203) 302-9378
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295281178
—
CT
Enumeration date
03/21/2021
Last updated
09/02/2022
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