Organization
DBA SUMMIT PSYCHOTHERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP WIENER LCSW (OWNER)
(860) 798-8558
Entity
Organization
Contact information
Practice address
24 RICHMOND LN, WEST HARTFORD, CT 06117-1628
(860) 798-8558
(203) 283-9235
Mailing address
24 RICHMOND LN, WEST HARTFORD, CT 06117-1628
(860) 798-8558
(203) 283-9235
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336280593
TYPE I NPI
CT
Enumeration date
08/08/2022
Last updated
08/25/2022
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