Provider Demographics
NPI:1760728349
Name:STECK, GARY M (LMFT)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:M
Last Name:STECK
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:141 E MAIN ST
Practice Address - Street 2:4TH FLOOR ADMINISTRATION
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2310
Practice Address - Country:US
Practice Address - Phone:203-574-9000
Practice Address - Fax:203-574-9006
Is Sole Proprietor?:No
Enumeration Date:2012-12-30
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT695106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060669107OtherOXNARD/FREEDOM LIBERTY/UBH WELLMORE GRP/FACILITY
12671501OtherCAQH
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT060669107OtherAETNA BEHAVIORAL HEALTH
CT060669107OtherOPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY
CT14205OtherBEACON HEALTH
CT060669107OtherUNITED HEALTHCARE/UBH WELLMORE GRP/FACILITY
4853965OtherCIGNA BEHAVIORAL HEALTH
CT008049729Medicaid
CT060669107OtherCONNECTICARE/UBH WELLMORE GRP/FACILITY
CTELIGIBLEOtherMHN MANAGED HEALTH NETWORK
CTELIGIBLEOtherMHN TRICARENORTH
CT060669107OtherUNITED HEALTHCARE/UBH WELLMORE GRP/FACILITY