Organization
COURAGE TO GROW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN J ISAAC LCSW (OWNER)
(860) 664-3592
Entity
Organization
Contact information
Practice address
162 B EAST MAIN STREET, COURAGE TO GROW, LLC, CLINTON, CT 06413
(860) 664-3592
(860) 664-3906
Mailing address
162 B EAST MAIN STREET, CLINTON, CT 06413
(860) 664-3592
(860) 664-3906
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005911
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062-0087436
UNITED HEALTHCARE SERVICES, INC.
CT
05
—
008002029
—
CT
01
—
140005911CT01
ANTHEM
CT
01
—
469787
MHN
CT
01
—
9560177
AETNA
CT
01
—
P4074057
OXFORD
CT
Enumeration date
07/26/2011
Last updated
07/26/2011
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