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Individual

MR. SCOTT I GOLDSMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S., LPC

Contact information

Practice address
200 MAIN ST, MANCHESTER, CT 06042-3581
(860) 646-9668
(860) 643-4074
Mailing address
21 MARLBORO GLADE, TOLLAND, CT 06084-3554
(860) 875-1418

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000820
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
240000820CT02
BLUE CROSS
CT
01
281894
MENTAL HEALTH NETWORK
CT
Enumeration date
10/12/2006
Last updated
07/08/2007
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