Stacie Leigh Kervin | Cheshire, CT • PECOS Search

Stacie Leigh Kervin

Counselor

Behavioral Health & Social Service Providers

116 S Brooksvale Rd, Cheshire, CT 06410-3512

PECOS Enrollment

Based on the most recent information from CMS, provider Stacie Leigh Kervin does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1316101348
Provider Type
Individual
Full Name
Kervin, Stacie Leigh
Credential
LPC, NCC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/18/2008
Last Updated
7/18/2008

Contact Information

Practice Location

116 S Brooksvale Rd, Cheshire, CT 06410-3512

Unlisted Fax

Mailing Location

116 S Brooksvale Rd, Cheshire, CT 06410-3512

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 001705 Connecticut