Organization
ICON HEALTH CORP
Active
Organization
ICON HEALTH CORP
Active
Other names
Iconn Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AMIR GHAEENZADEH (CORPORATE COUNSEL)
(813) 482-1239
Entity
Organization
Contact information
Practice address
1 KENNEDY AVE UNIT 2136, DANBURY, CT 06810-5995
(813) 482-1239
Mailing address
1 KENNEDY AVE UNIT 2136, DANBURY, CT 06810-5995
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
11/23/2018
Last updated
11/23/2018
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