Healthcare Provider Details

I. General information

NPI: 1851224570
Provider Name (Legal Business Name): ROOT & RIDGE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 PARK CIR
MILFORD CT
06460-4832
US

IV. Provider business mailing address

34 PARK CIR
MILFORD CT
06460-4832
US

V. Phone/Fax

Practice location:
  • Phone: 203-903-4774
  • Fax:
Mailing address:
  • Phone: 203-903-4774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: AUTUMN A CHASE
Title or Position: OWNER
Credential: LPC
Phone: 203-903-4774