Conway, Mary T

Conway, Mary T is an individual health care provider with primary practice located at 47 Town St , Norwich CT 06360-2315. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Conway, Mary T can be contacted via phone (860) 892-7042.

Contact Information

Primary practice address
47 Town St Norwich CT 06360-2315
Phone: (860) 892-7042
Fax: (860) 823-3060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 6401008004 Michigan
Behavioral Health & Social Service Providers / Professional 101YP2500X 001624 Connecticut

Profile Details

NPI number 1043334790
LBN Legal business name Conway, Mary T
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 19th, 2007
Last updated Aug 5th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043334790 NPPES
Connecticut MEDICAID 004264066

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