Douglas Scott Eads, LMFT

Individual provider Active NPI Marriage & Family Therapist · Old Lyme, CT

NPI 1780844852 · NPPES record last updated Nov 20, 2024

Key facts

NPI
1780844852
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFC45843 (CA)
Practice address
12 Halls Rd Unit 30
Old Lyme, CT 06371-7006
Phone
(323) 304-0489
NPI assigned
Jun 12, 2008
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

State licenses

LicenseStateTypeSpecialty
MFC45843CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC45843 CA Yes

Addresses

Primary practice location

12 Halls Rd Unit 30
Old Lyme, CT 06371-7006

Mailing address

12 Halls Rd Unit 30
Old Lyme, CT 06371-7006
Phone (323) 304-0489

Other providers in Old Lyme, CT

All providers in Old Lyme, CT · Marriage & Family Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.