Organization
CENTRAL CONNECTICUT PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAUREEN PICKUP LCSW (SOLE MEMBER)
(860) 337-7144
Entity
Organization
Contact information
Practice address
23 LIBERTY DR, SUITE 23 B-1, HEBRON, CT 06248
(860) 337-7144
(860) 337-7155
Mailing address
23 LIBERTY DR, SUITE B-1, HEBRON, CT 06248-1553
(860) 337-7144
(860) 337-7155
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
006447
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033187539
INDIVIDUAL NPI
CT
Enumeration date
03/10/2009
Last updated
03/10/2009
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