Individual
MISS KELLY URBANOWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, LPC
Contact information
Practice address
276 BANK ST, SEYMOUR, CT 06483-2700
(203) 446-7461
(203) 463-8745
Mailing address
20 WANDA DR, BEACON FALLS, CT 06403-1532
(203) 446-7461
(203) 463-8745
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MHC00169
RI
101YP2500X
Professional Counselor
Primary
002187
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1031310
NHP-RI
RI
01
—
27262-9
BCBS
RI
01
—
412332
BCBS BLUE CHIP
RI
01
—
486309
TUFTS TOTAL HEALTH PLAN
RI
05
—
KU53902
—
RI
Enumeration date
10/18/2006
Last updated
06/11/2012
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