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GEORGIA G HYNES CCDP,CCS,CAC,NCACII

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1134269210

Individual Registrant:
 GEORGIA G HYNES CCDP,CCS,CAC,NCACII
Gender: F
Not Sole Proprietor

Location and contact information for practice:
8 TITUS RD BOX 560 WASHINGTON DEPOT, CT 06794-1517 US
Tel: 860-868-0857  Fax: 860-868-1288

Contact information for business:
8 TITUS RD P.O. BOX 560 WASHINGTON DEPOT, CT 06794-1517 US
Tel: 860-868-0857  Fax: 860-868-1288

Registration Information:
NPI: 1134269210
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
CT000322
N101YM0800XBehavioral Health & Social Service Providers
Counselor
CT000322

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CONNECTICUT CERTIFICATION BOARDCCS-1410CT01
NEW YORK STATE OASASCAC-4490NY01
STATE OF CT DEPARTMENT OF PUBLIC HEALTH000322CT01
CONNECTICUT CERTIFICATION BOARDCAC-1410CT01
CONNECTICUT CERTIFICATION BOARDCCDP-1410CT01
NAADACNCACII -004029VA01




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