Mark Landry
Individual provider Active NPI Marriage & Family Therapist · Stafford Springs, CT
NPI 1164639191 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164639191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- Practice address
- 21 Hyde Park Rd
Stafford Springs, CT 06076-1507 - Phone
- (860) 684-4239
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Yes |
Addresses
Primary practice location
21 Hyde Park Rd
Stafford Springs, CT 06076-1507
Mailing address
62 Clubhouse Dr
Cromwell, CT 06416-2564
Phone (860) 632-7190
Other providers in Stafford Springs, CT
- Johnson Memorial Hospital, Inc.
- Johnson Professional Associates, PC
- Laura Marie Kielb
- Cheryl Ann Kilcollins
- Sharon Kozey Greene
- Nicole Lemek
- Bethany Lewis
- Elayna Joy Lindblom
- Renee Logan
- Donna Lowney
All providers in Stafford Springs, CT · Marriage & Family Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.