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General NPI Number Information
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NPI Number | 1073914578
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Entity Type | Organization
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Legal Business Name | RESOURCE CENTER
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 14 S MAIN ST
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City | THOMASTON
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State | CT
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Zip | 06787-1734
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Country | US
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Telephone | 203-578-5072
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Fax |
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Provider Business Mailing Address
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Address Line | 14 S MAIN ST
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City | THOMASTON
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State | CT
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Zip | 06787-1734
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Country | US
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Telephone | 203-578-5072
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HERBERT L HALL
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Credential | LPC
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Telephone | 203-578-5072
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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 | 005428
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 001328
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License Number State | CT
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