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Organization

WALTER VAN SAMBECK

Active
Other names
Connecticut Center for Human Growth& Dev.
Organization subpart
No

Provider details

NPI number
Authorized official
WALTER JOHANNES VAN SAMBECK (OWNER)
(860) 537-3977
Entity
Organization

Contact information

Practice address
244 S MAIN ST, COLCHESTER, CT 06415-1405
(860) 537-3977
Mailing address
244 S MAIN ST, COLCHESTER, CT 06415-1405
(860) 537-3977

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000493
CT
101YP2500X
Professional Counselor
Primary
000493
CT
103TP0016X
Prescribing (Medical) Psychologist
023879
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1275632994
NPI
01
1437218823
NPI
Enumeration date
12/10/2007
Last updated
06/16/2008
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