Organization
THE MINDWELL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEVON BICKFORD SUOZZI LCSW (FOUNDER/SUPERVISING PSYCHOTHERAPIST)
(203) 594-7677
Entity
Organization
Contact information
Practice address
45 PINE STREET SUITE NUMBERS 4A & 6A, NEW CANAAN, CT 06840
Mailing address
45 PINE STREET SUITE NUMBERS 4A & 6A, NEW CANAAN, CT 06840
(203) 801-8180
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912298894
NPI
—
Enumeration date
07/31/2023
Last updated
07/31/2023
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