Individual
SAMANTHA BIRTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,BA,LMFT
Contact information
Practice address
731 MAIN ST STE 122, MONROE, CT 06468-2872
(203) 261-7090
(203) 702-5283
Mailing address
13 ROOSEVELT DR, NEWTOWN, CT 06470-2035
(203) 300-6414
(203) 702-5283
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1736
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008062567
—
CT
01
—
060669017
UBH-OXFORD HEALTH/FREEDOM/LIBERTY WELLMORE GRP/FACILITY
CT
01
—
060669107
UBH-UNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
CT
01
—
13584798
CAQH
CT
01
—
ACTIVE MEMBER
AAMFT
CT
01
—
D339123 141 E MAIN
VALUE OPTIONS
CT
01
—
PENDING
CIGNA BEHAVIORAL HEALTH
CT
Enumeration date
05/19/2014
Last updated
07/24/2020
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