Individual
DR. STEVEN MOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD CLINICAL PSYCHOL
Contact information
Practice address
380 MAIN ST, WATERTOWN, CT 06795
(860) 274-6069
Mailing address
66 LOVELACE DR, WEST HARTFORD, CT 06117
(860) 232-1962
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
CT000319
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060000319CT02
ANTHEM BCBS
CT
01
—
211983
MHN
—
Enumeration date
04/25/2007
Last updated
07/08/2007
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