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Organization

COMMUNITY MATTERS OUTPATIENT PSYCHIATRIC CLINIC FOR CHILDREN, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TANGIE R MCDOUGALD LPC (LICENSED PROFESSIONAL COUNSELOR)
(860) 282-8882
Entity
Organization

Contact information

Practice address
531 MAIN ST, EAST HARTFORD, CT 06108-3305
(860) 282-8882
(860) 282-8890
Mailing address
122 HARBISON AVE, HARTFORD, CT 06106-3013
(860) 282-8882
(860) 282-8890

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
261Q00000X
Clinic/Center
261QC1500X
Community Health Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
11/04/2020
Last updated
11/04/2020
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