Individual
MR. CHRISTOPHER J LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
113 ELM ST STE 204, ENFIELD, CT 06082-3739
(860) 741-3001
(860) 741-8332
Mailing address
113 ELM ST STE 204, ENFIELD, CT 06082-3739
(860) 741-3001
(860) 741-8332
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000476
CT
101YM0800X
Mental Health Counselor
000061
CT
101YM0800X
Mental Health Counselor
3665
MA
101YP2500X
Professional Counselor
000061
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300000476CT01
ANTHEM BC/BS
CT
01
—
301508
MANAGED HEALTH NETWORK
CT
01
—
321137
VALUE OPTIONS
CT
01
—
A412956
OXFORD INSURANCE
CT
01
—
CTGA000477-B001475
STATE ADMINISTER ASST.
CT
Enumeration date
03/07/2008
Last updated
03/07/2008
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