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Individual

SAMUEL R SEGAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, LADC

Contact information

Practice address
88 GRANDVIEW AVE, WEST MAIN BEHAVIORAL HEALTH, WATERBURY, CT 06708-2509
(203) 573-6103
(203) 573-7578
Mailing address
88 GRANDVIEW AVE, WEST MAIN BEHAVIORAL HEALTH, WATERBURY, CT 06708-2509
(203) 573-6103
(203) 573-7578

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000287
CT
101YP2500X
Professional Counselor
000006
CT

Other

Enumeration date
11/07/2007
Last updated
11/07/2007
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