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Organization

COMMUNITY GUIDANCE CLINIC FOR CENTRAL CONNECTICUT, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS WANDA IVELISSE RODRIGUEZ (BILLING ADMINISTRATOR)
(203) 235-5767
Entity
Organization

Contact information

Practice address
384 PRATT ST, MERIDEN, CT 06450
(203) 235-5767
(203) 238-2010
Mailing address
384 PRATT ST, MERIDEN, CT 06450
(203) 235-5767
(203) 238-2010

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004039210
CT
Enumeration date
01/08/2007
Last updated
02/24/2025
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