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07D2051066 CLIA NUMBER - STRATFORD HEALTH DEPARTMENT WELL CHILD CLINIC

Laboratory Demographics

CLIA Number: 07D2051066

Facility Name: STRATFORD HEALTH DEPARTMENT WELL CHILD CLINIC

Facility Address:
STRATFORD HEALTH DEPARTMENT 468 BIRDSEYE ST
STRATFORD, CT
ZIP 06615
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Facility Phone Number: 203 385-4090

Facility Type: Other - WELL CHILD CLINIC

Certificate Type: Waiver
NPI Number: 1851695837

Taxonomy: 106H00000X - Marriage & Family Therapist
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

CLIA Record

Field Name Field Value
CLIA Number 07D2051066
LAB Type Other - WELL CHILD CLINIC
Facility Name STRATFORD HEALTH DEPARTMENT WELL CHILD CLINIC
Street STRATFORD HEALTH DEPARTMENT 468 BIRDSEYE ST
City STRATFORD
State CT
ZIP 06615
Phone 203 385-4090
CertificateType 4
CertificateEffectiveDate 12/12/2022
CertificateExpirationDate 12/11/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024