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General NPI Number Information
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NPI Number | 1063908507
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Entity Type | Organization
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Legal Business Name | GIRARD COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 182 GRAND ST STE 219
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City | WATERBURY
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State | CT
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Zip | 06702-1914
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Country | US
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Telephone | 203-423-3546
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Fax | 203-841-1184
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Provider Business Mailing Address
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Address Line | 405 BIOSKI RD
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City | MIDDLEBURY
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State | CT
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Zip | 06762-3619
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Country | US
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Telephone | 203-423-3546
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT ASHLEY GIRARD II
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Credential | LMSW, LADC
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Telephone | 203-423-3546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1206
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1206
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License Number State | CT
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