Organization
BACKCOUNTRY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOANN S. BRONFMAN LCSW, PSY.D (OWNER/DIRECTOR)
(914) 755-6472
Entity
Organization
Contact information
Practice address
7 LINCOLN AVENUE, GREENWICH, CT 06830
(203) 992-1700
Mailing address
7 LINCOLN AVENUE, GREENWICH, CT 06830
(203) 992-1700
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CT006838
CT
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/21/2018
Last updated
03/04/2021
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