Garrett Thomas Deutermann, LADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Canaan, CT

NPI 1225925191 · NPPES record last updated Jun 23, 2025

Key facts

NPI
1225925191
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
1592 (CT)
Practice address
22 Prospect St
Canaan, CT 06018-2030
Phone
(860) 541-1947
NPI assigned
Jun 23, 2025
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1592CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Full of Life Counseling and Addiction Services, PLLC Addiction (Substance Use Disorder) Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1592 CT Yes

Addresses

Primary practice location

22 Prospect St
Canaan, CT 06018-2030

Mailing address

22 Prospect St
Canaan, CT 06018-2030
Phone (860) 541-1947

Other providers in Canaan, CT

All providers in Canaan, CT · Addiction (Substance Use Disorder) Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.