Walker, George Mcgwaine
Walker, George Mcgwaine is an sole proprietor health care provider with primary practice located at 78 Michael Rd Apt D , New London CT 06320-2453. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Walker, George Mcgwaine can be contacted via phone (561) 702-9788.Contact Information
Primary practice address
78 Michael Rd Apt D
New London CT 06320-2453
Phone: (561) 702-9788
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 002095 | Connecticut |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 002095 | Connecticut |
Profile Details
| NPI number | 1275899692 |
|---|---|
| LBN Legal business name | Walker, George Mcgwaine |
| Credentials | PHD, LPC, NCC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 10th, 2012 |
| Last updated | Jul 29th, 2021 - about 3 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 | 1275899692 | NPPES |
| Connecticut | Other | 4553929 | AETNA |
| Connecticut | MEDICAID | 004121141 | AETNA |
| Connecticut | Other | 321137/A324839 | AETNA |
| Connecticut | Other | 201366 | AETNA |
| Connecticut | Other | A412956 | AETNA |
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