Organization
CONNECTICUT BEHAVIORAL HEALTH ASSOC. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA ADCOCK (ADMIN.)
(860) 437-6914
Entity
Organization
Contact information
Practice address
41 FAIR HARBOUR PL, NEW LONDON, CT 06320-4710
(860) 437-6910
(860) 437-6920
Mailing address
41 FAIR HARBOUR PL, NEW LONDON, CT 06320-4710
(860) 437-6910
(860) 437-6920
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004255388
ST OF CONN GRP #S SCWKRS)
CT
Enumeration date
05/25/2007
Last updated
04/25/2012
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