Organization
CT PSYCHOLOGICAL & ASSESSMENT CENTER,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIAM MARTINEZ MA (OWNER)
(860) 904-3444
Entity
Organization
Contact information
Practice address
61 WELLS RD, WETHERSFIELD, CT 06109-3043
(860) 372-4811
(860) 372-4812
Mailing address
61 WELLS RD, WETHERSFIELD, CT 06109-3043
(860) 372-4811
(860) 372-4812
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001997
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008025895
—
CT
Enumeration date
07/14/2011
Last updated
07/14/2011
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