Organization
ECLIPSE DEPRESSION CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAY SEAN WILSON LCSW (C.E.O)
(203) 675-5371
Entity
Organization
Contact information
Practice address
20 WOODSIDE AVE, MIDDLEBURY, CT 06762
(203) 675-5371
Mailing address
20 WOODSIDE AVE, MIDDLEBURY, CT 06762
(203) 675-5371
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008108610
—
CT
Enumeration date
04/12/2022
Last updated
04/12/2022
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