Individual
KATHY MEDBERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
50 BEECH MOUNTAIN RD, MANSFIELD CENTER, CT 06250-1603
(860) 423-8147
(860) 423-8147
Mailing address
50 BEECH MOUNTAIN RD, MANSFIELD CENTER, CT 06250-1603
(860) 423-8147
(860) 423-8147
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000213
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007094313
AETNA
CT
01
—
11243562
CAQH
CT
01
—
240000213CT07
ANTHEM
CT
Enumeration date
09/02/2006
Last updated
07/08/2007
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