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General NPI Number Information
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NPI Number | 1114663200
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Entity Type | Organization
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Legal Business Name | FLOWING RIVER COUNSELING, LLC
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 51 DEPOT ST STE 202
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City | WATERTOWN
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State | CT
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Zip | 06795-2667
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Country | US
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Telephone | 860-506-5200
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Fax | 860-506-5272
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Provider Business Mailing Address
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Address Line | 51 DEPOT ST STE 202
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City | WATERTOWN
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State | CT
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Zip | 06795-2667
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Country | US
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Telephone | 860-506-5200
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Fax | 860-506-5272
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | EVETTE CORUJO-AIRD
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Credential | LPC
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Telephone | 860-506-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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