Provider Demographics
NPI:1700089257
Name:CLIFFORD BEERS CLINIC
Entity type:Organization
Organization Name:CLIFFORD BEERS CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:LUCIA
Authorized Official - Last Name:PLAZAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-777-8648
Mailing Address - Street 1:249 THORNTON ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-1325
Mailing Address - Country:US
Mailing Address - Phone:203-230-5823
Mailing Address - Fax:
Practice Address - Street 1:370 JAMES ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-3089
Practice Address - Country:US
Practice Address - Phone:203-777-8648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000689261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)