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07D2222446 CLIA NUMBER - MC DIAGNOSTIC OF CONNECTICUT, PC

Laboratory Demographics

CLIA Number: 07D2222446

Facility Name: MC DIAGNOSTIC OF CONNECTICUT, PC

Facility Address:
519 BOSTON POST RD
OLD SAYBROOK, CT
ZIP 06475
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Facility Phone Number: 860 388-1145

Facility Type: Other - LMT. SERV. HEALTH CLINIC

Certificate Type: Waiver
NPI Number: 1831857861

Taxonomy: 1041C0700X - Social Worker
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

CLIA Record

Field Name Field Value
CLIA Number 07D2222446
LAB Type Other - LMT. SERV. HEALTH CLINIC
Facility Name MC DIAGNOSTIC OF CONNECTICUT, PC
Street 519 BOSTON POST RD
City OLD SAYBROOK
State CT
ZIP 06475
Phone 860 388-1145
CertificateType 4
CertificateEffectiveDate 4/29/2023
CertificateExpirationDate 4/28/2025
FacilityType Waiver

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