Healthcare Provider Details

I. General information

NPI: 1205131059
Provider Name (Legal Business Name): COUNSELING CENTER FOR ELDERS AND FAMILIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2011
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 WASHINGTON AVE SUITE 5N
HAMDEN CT
06518-3025
US

IV. Provider business mailing address

17 BEACH AVE
MILFORD CT
06460-8202
US

V. Phone/Fax

Practice location:
  • Phone: 203-878-7619
  • Fax:
Mailing address:
  • Phone: 203-878-7619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURA H KAPLAN
Title or Position: SOLE PROPRIETOR
Credential: LCSW
Phone: 203-878-7619