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General NPI Number Information
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NPI Number | 1043017478
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Entity Type | Organization
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Legal Business Name | PLACES RECOVERY AND PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 212 SCHOOL ST
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City | MANCHESTER
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State | CT
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Zip | 06040-6184
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Country | US
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Telephone | 860-995-2622
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Fax |
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Provider Business Mailing Address
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Address Line | 212 SCHOOL ST
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City | MANCHESTER
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State | CT
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Zip | 06040-6184
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PRISELLA MICHELLE KING
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Credential | LMSW, LADC
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Telephone | 860-995-2622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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