Gonsalves, Krystina A
Gonsalves, Krystina A is an sole proprietor health care provider with primary practice located at 300 Church St , Wallingford CT 06492-2253. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gonsalves, Krystina A can be contacted via phone (203) 668-7526.Contact Information
Primary practice address
300 Church St
Wallingford CT 06492-2253
Phone: (203) 668-7526
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 006425 | Connecticut |
Profile Details
| NPI number | 1437354925 |
|---|---|
| LBN Legal business name | Gonsalves, Krystina A |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2007 |
| Last updated | Dec 19th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437354925 | NPPES |
| Connecticut | Other | 397083 | MHN |
| Connecticut | Other | 140006425CT01 | MHN |
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