Organization
SAINT FRANCIS BEHAVIORAL HEALTH GROUP, P.C.
Active
Other names
PATH OUTPATIENT SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA KIDA (BUSINESS MANAGER)
(860) 714-9333
Entity
Organization
Contact information
Practice address
675 TOWER AVENUE, SUITE 301, HARTFORD, CT 06112-1260
(860) 714-2750
(860) 714-8591
Mailing address
675 TOWER AVE, SUITE 301, HARTFORD, CT 06112-1273
(860) 714-2750
(860) 714-8591
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
CT
103TC0700X
Clinical Psychologist
—
CT
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004197788
—
CT
05
—
004210069
—
CT
05
—
004210481
—
CT
05
—
004245909
—
CT
05
—
004255891
—
CT
05
—
004255966
—
CT
05
—
004256013
—
CT
01
—
50PATHPCICT01
ANTHEM BC/BS GROUP #
CT
Enumeration date
06/03/2006
Last updated
01/28/2014
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