Healthcare Provider Details

I. General information

NPI: 1265109607
Provider Name (Legal Business Name): SCT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 CARIATI BLVD
MERIDEN CT
06451-3683
US

IV. Provider business mailing address

139 CARIATI BLVD
MERIDEN CT
06451-3683
US

V. Phone/Fax

Practice location:
  • Phone: 203-654-5812
  • Fax:
Mailing address:
  • Phone: 203-654-5812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA TURNER
Title or Position: SOLE MEMBER
Credential: LPC
Phone: 203-654-5812