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Contact Information

JONATHAN C BEAZLEY
384 MERROW RD STE D
TOLLAND, CT06084-3957
 Phone: 860-875-2578
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Marriage & Family Therapist

106H00000X
Indicates primary specialty

NPI Profile & details for JONATHAN C BEAZLEY · (Male)

NPI # 1619185469
Status Active
Credentials
Entity Individual
Enumeration date 05/17/2007
Last updated 10/09/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • CT License # 000631
  • CT Other 410000631CT02 ANTHEM BLUE CROSS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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