Healthcare Provider Details
I. General information
NPI: 1699593152
Provider Name (Legal Business Name): CARE COUNSELING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
559 HARTFORD PIKE STE 208
DAYVILLE CT
06241-2153
US
IV. Provider business mailing address
559 HARTFORD PIKE STE 208
DAYVILLE CT
06241-2153
US
V. Phone/Fax
- Phone: 959-995-0775
- Fax: 959-901-0078
- Phone: 959-995-0775
- Fax: 959-901-0078
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CARRIE
B.
VARGAS
Title or Position: PSYCHOLOGIST/OWNER
Credential:
Phone: 959-995-0776