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Organization

CLINICIANS COVE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS SPELLS (CTO)
(475) 238-2010
Entity
Organization

Contact information

Practice address
2505 MAIN ST STE 223, STRATFORD, CT 06615-5839
(475) 238-2010
Mailing address
25 WILLARD ST, STRATFORD, CT 06615-6924

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
05/09/2024
Last updated
05/10/2024
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