Organization
BLACK & MENTAL HEATLH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYANN L PINTO-SAMUDA LCSW (THERAPIST)
(203) 536-3199
Entity
Organization
Contact information
Practice address
96 SILVER LN APT B7, EAST HARTFORD, CT 06118-1006
(203) 536-3199
Mailing address
96 SILVER LN APT B7, EAST HARTFORD, CT 06118-1006
(203) 536-3199
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
1041S0200X
School Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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