Michael Hanrahan

Individual provider Active NPI Professional Counselor · Kent, CT

NPI 1386301414 · NPPES record last updated Nov 23, 2021

Key facts

NPI
1386301414
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
003688 (CT)
Practice address
62 Carter Road
Kent, CT 06757
Phone
(860) 927-3772
NPI assigned
Nov 23, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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
003688CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Medop Behavioral Health Associates PC Past
since Nov 28, 2021
Accepting new patients
High Watch Recovery Center Past
since Nov 28, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 003688 CT Yes

Addresses

Primary practice location

62 Carter Road
Kent, CT 06757

Mailing address

18 Shortwoods Rd
New Fairfield, CT 06812-3216
Phone (203) 994-6149

Other providers in Kent, CT

All providers in Kent, CT · Professional Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.