Organization
KHMER HEALTH ADVOCATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THEANVY KUOCH MA, LPC (EXECUTIVE DIRECTOR)
(860) 561-3345
Entity
Organization
Contact information
Practice address
1125 NEW BRITAIN AVE, SUITE 202, WEST HARTFORD, CT 06110-2440
(860) 561-3345
(860) 561-3538
Mailing address
1125 NEW BRITAIN AVE, SUITE 202, WEST HARTFORD, CT 06110-2420
(860) 561-3345
(860) 561-3538
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
000638
CT
2084P0800X
Psychiatry Physician
Primary
014898
CT
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
003364
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008035322
—
CT
Enumeration date
05/03/2011
Last updated
10/24/2016
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