person
Marie T. Clavecilla-chan, MA
Professional Counselor in Newington, Connecticut
NPI 1598807810

Marie T. Clavecilla-chan is a Professional Counselor based in Newington, CT and is specialized in Professional. Marie T. Clavecilla-chan practices in Newington, CT and has the professional credentials of MA. The NPI Number for Marie T. Clavecilla-chan is 1598807810 and holds a License No. 001481 (Connecticut).

The current practice location address for Marie T. Clavecilla-chan is 100 Market Sq, Newington, CT and can be reached out via phone at 860-665-1025 and via fax at 860-667-6008.

Location: 100 Market Sq, Newington, CT, 06111-2921
person
Provider Profile Details
NPI Number
1598807810
Provider Name
Marie T. Clavecilla-chan
Credential
MA
Provider Entity Type
Individual
Gender
Female
Address
100 Market Sq, Newington, CT, 06111-2921
Phone Number
860-665-1025
Fax Number
860-667-6008
Provider Enumeration Date
02/13/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
240001481CT01 01 CT ANTHEM BEHAVIORAL HEALTH
004257912 01 CT CT MEDICAL ASSITANCE PROG
institution
Provider Business Practice Location Address Details
Address
100 Market Sq
City
State
Zip
06111-2921
Phone Number
860-665-1025
Fax Number
860-667-6008
person
Provider Business Mailing Address Details
Address
100 Market Sq
City
State
Zip
06111-2921
Phone Number
860-665-1025
Fax Number
860-667-6008
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
001481 (Connecticut)
Definition
Definition to come...
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