Provider Demographics
NPI:1639220387
Name:VISCOSI, LOUIS VINCENT III (MS LPC)
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:VINCENT
Last Name:VISCOSI
Suffix:III
Gender:M
Credentials:MS LPC
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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:WATERBURY CLINICAL SERVICES 2ND FLOOR
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2310
Practice Address - Country:US
Practice Address - Phone:203-756-7387
Practice Address - Fax:203-596-0722
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2015-12-24
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Provider Licenses
StateLicense IDTaxonomies
CT0004655101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004254885Medicaid
CT347109OtherMHN MANAGED HEALTH NETWORK
CTD339209OtherVALUE OPTIONS/BEACON HEALTH STRATEGIES
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT11341132OtherCAQH
CT060669107OtherUNITED BEHAVIORAL HEALTH - WELLMORE GRP/FACILITY
CT060669107OtherUBH-OXFORD HEALTH FREEDOM/LIBERTY WELLMORE, INC.
CT347109OtherMHN TRICARE NORTH
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE FACILITY/GRP
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CT060669107OtherUBH- CONNECTICARE WELLMORE GRP/FACILTY
CT347109OtherMHN TRICARE NORTH