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General NPI Number Information
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NPI Number | 1083930093
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Entity Type | Organization
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Legal Business Name | L&M COUNSELING SERVICES
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 2911 DIXWELL AVE
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City | HAMDEN
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State | CT
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Zip | 06518-3195
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Country | US
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Telephone | 203-288-0156
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Fax |
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Provider Business Mailing Address
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Address Line | 2911 DIXWELL AVE
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City | HAMDEN
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State | CT
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Zip | 06518-3195
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Country | US
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Telephone | 203-288-0156
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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. RENE EVARISTE RUDEL
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Credential | L.C.S.W.
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Telephone | 203-288-0156
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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 | 006587
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License Number State | CT
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