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Individual

HARRY A GEROWE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS,LADC,CCS,CCDP

Contact information

Practice address
900 WATERTOWN AVE, WATERBURY, CT 06708-2011
(203) 756-8984
(203) 756-8984
Mailing address
900 WATERTOWN AVE, WATERBURY, CT 06708-2011
(203) 756-8984
(203) 756-8984

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000118
CT
101YM0800X
Mental Health Counselor
000118
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000118
LICENSED ALCOHOL AND DRUG
CT
01
CAC - 588
CONNECTICUT CERTIFICATION BOARD
CT
01
CCDP - 4884
CONNECTICUT CERTIFICATION BOARD
CT
01
CCS - 588
CONNECTICUT CERTIFICATION BOARD
CT
Enumeration date
07/13/2007
Last updated
10/25/2013
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