Organization
BREAKWATER COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE MARTIN LPC (OWNER/COUNSELOR)
(203) 693-1169
Entity
Organization
Contact information
Practice address
1110 BROADBRIDGE AVE, STRATFORD, CT 06615-5801
(203) 693-1169
Mailing address
1110 BROADBRIDGE AVE, STRATFORD, CT 06615-5801
(203) 693-1169
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003183
STATE OF CT DPH
CT
01
—
CBHP009329
BEACON HEALTH
CT
Enumeration date
03/22/2018
Last updated
07/24/2019
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