Organization
WELLMORE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY STECK LMFT (EXECUTIVE DIRECTOR)
(203) 756-7287
Entity
Organization
Contact information
Practice address
141 E MAIN ST, WATERBURY, CT 06702-2310
(203) 756-7287
(203) 596-0722
Mailing address
141 E MAIN ST, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
OPCC-11
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004039202
—
CT
01
—
4491935
CIGNA BEHAVIORAL HEALTH
CT
01
—
9211645
AETNA HEALTH
CT
01
—
D339123 WATERBURY
BECON HEALTH STRATEGIES
CT
01
—
GRP/FACILITY
ANTHEM BCBS OF CT
CT
Enumeration date
11/06/2006
Last updated
08/23/2016
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