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General NPI Number Information
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NPI Number | 1023384450
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Entity Type | Organization
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Legal Business Name | COUNSELING SOLUTIONS OF CHESHIRE, LLC
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 345 HIGHLAND AVE 102
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City | CHESHIRE
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State | CT
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Zip | 06410-2550
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Country | US
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Telephone | 203-272-3055
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Fax | 203-272-3303
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Provider Business Mailing Address
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Address Line | 345 HIGHLAND AVE 102
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City | CHESHIRE
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State | CT
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Zip | 06410-2550
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Country | US
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Telephone | 203-272-3055
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Fax | 203-272-3303
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | CYNTHIA ANNE GIRARD
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Credential | L.C.S.W.
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Telephone | 203-272-3055
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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 | 005315
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License Number State | CT
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