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MARIANNE ROBERTS CARROLL MA LADC

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

Registrant NPI Number: 1417056060

Individual Registrant:
 MARIANNE ROBERTS CARROLL MA LADC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
387 TUCKIE RD D NORTH WINDHAM, CT 06256-1355 US
Tel: 860-423-4279  Fax: 860-423-4284

Contact information for business:
387 TUCKIE RD D NORTH WINDHAM, CT 06256-1355 US
Tel: 860-423-4279  Fax: 860-423-4284

Registration Information:
NPI: 1417056060
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
CT000055

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
004255007CT05
MHN199589CT01
ANTHEM300000055CT01CT01
VALUE OPTIONS16592701
OXFORDP263366401




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