Organization
INTERFACE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE A MCNALLY (OFFICE MANAGER)
(860) 354-1596
Entity
Organization
Contact information
Practice address
46 DANBURY RD, SUITE 6, NEW MILFORD, CT 06776
(860) 354-1596
(860) 350-2189
Mailing address
46 DANBURY RD, SUITE 6, NEW MILFORD, CT 06776
(860) 354-1596
(860) 350-2189
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
000964
CT
103TC0700X
Clinical Psychologist
001600
CT
1041C0700X
Clinical Social Worker
Primary
002524
CT
1041C0700X
Clinical Social Worker
002699
CT
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002524
ANTHEM
—
Enumeration date
10/23/2006
Last updated
03/20/2020
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