Healthcare Provider Details

I. General information

NPI: 1528573789
Provider Name (Legal Business Name): RMS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 12/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 N MAIN ST
BRANFORD CT
06405-3032
US

IV. Provider business mailing address

57 MYRON ST
NEW HAVEN CT
06512-3950
US

V. Phone/Fax

Practice location:
  • Phone: 203-645-5563
  • Fax:
Mailing address:
  • Phone: 203-506-6455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2994
License Number StateCT

VIII. Authorized Official

Name: REBECCA SULLIVAN
Title or Position: COUNSELOR
Credential: LPC
Phone: 203-645-5563