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Organization

CT PSYCHOLOGICAL & ASSESSMENT CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LILLIAM MARTINEZ LPC (OWNER)
(860) 372-4811
Entity
Organization

Contact information

Practice address
61 WELLS RD, WETHERSFIELD, CT 06109-3043
(860) 372-4811
(860) 372-4812
Mailing address
1028 MANCHESTER RD, GLASTONBURY, CT 06033-2617
(860) 372-4811
(860) 372-4812

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1997
CT
103TC1900X
Counseling Psychologist
1820
CT
1041C0700X
Clinical Social Worker
3634
CT
1041C0700X
Clinical Social Worker
4480
CT
1041C0700X
Clinical Social Worker
5985
CT
1041C0700X
Clinical Social Worker
7260
CT
1041C0700X
Clinical Social Worker
7279
CT
363L00000X
Nurse Practitioner
3809
CT

Other

Enumeration date
12/23/2010
Last updated
04/14/2014
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