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General NPI Number Information
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NPI Number | 1063846277
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Entity Type | Organization
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Legal Business Name | GREENWOODS COUNSELING REFERRALS, INC.
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Dates
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Enumeration Date | 08/23/2013
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Last Update Date | 03/02/2015
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Provider Practice Location Address
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Address Line | 25 SOUTH ST
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City | LITCHFIELD
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State | CT
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Zip | 06759-4005
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Country | US
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Telephone | 860-567-7724
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Fax | 860-567-0300
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Provider Business Mailing Address
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Address Line | PO BOX 1549 21 SOUTH STREET
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City | LITCHFIELD
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State | CT
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Zip | 06759-1549
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Country | US
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Telephone | 860-567-7724
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Fax | 860-567-0300
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DONNA R CAMPBELL
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Credential | LCSW
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Telephone | 860-567-7724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 000840
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 000840
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License Number State | CT
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