Provider Demographics
NPI:1508820713
Name:BEHLING, JOHN L (LCSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:BEHLING
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 HAYNES ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4131
Mailing Address - Country:US
Mailing Address - Phone:860-533-3434
Mailing Address - Fax:860-647-6829
Practice Address - Street 1:150 N MAIN ST
Practice Address - Street 2:SUITE 130
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-2086
Practice Address - Country:US
Practice Address - Phone:860-646-1222
Practice Address - Fax:869-647-6829
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0022571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004025177Medicaid
CT004025177Medicaid
CTC00006Medicare PIN