Basic Information
| Provider Information | |||||||||
| NPI: | 1174991970 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHON | ||||||||
| FirstName: | BRYAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 270 FARMINGTON AVE STE 328 | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060321909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668876864 | ||||||||
| FaxNumber: | 8608876864 | ||||||||
| Practice Location | |||||||||
| Address1: | 270 FARMINGTON AVE STE 328 | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060321909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668876864 | ||||||||
| FaxNumber: | 8608876864 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2015 | ||||||||
| LastUpdateDate: | 12/01/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 003797 | CT | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | 003797 | CT | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.