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General NPI Number Information
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NPI Number | 1083178289
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Entity Type | Organization
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Legal Business Name | ARROW OF CHANGE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 02/07/2019
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Provider Practice Location Address
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Address Line | 5 BAYVIEW PL FL 1
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City | WEST HAVEN
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State | CT
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Zip | 06516-4702
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Country | US
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Telephone | 475-422-4361
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Fax |
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Provider Business Mailing Address
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Address Line | 5 BAYVIEW PL FL 1
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City | WEST HAVEN
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State | CT
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Zip | 06516-4702
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Country | US
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Telephone | 475-422-4361
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | MISS DONNA MARIE UNDERHILL
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Credential | LADC, MSW
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Telephone | 475-422-4361
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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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