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General NPI Number Information
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NPI Number | 1013652064
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Entity Type | Organization
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Legal Business Name | PREMIER COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 57 PLAINS RD STE 1E
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City | MILFORD
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State | CT
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Zip | 06461-2573
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Country | US
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Telephone | 203-444-2565
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Fax | 203-306-3242
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Provider Business Mailing Address
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Address Line | 55 CHESTNUT LN
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City | MILFORD
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State | CT
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Zip | 06461-1861
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Country | US
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Telephone | 203-444-2565
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Fax | 203-306-3242
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER, OWNER
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Name | MELISSA ELLEN FLYNN
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Credential |
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Telephone | 203-444-2565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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