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NPI 1124258900

NPI 1124258900 : LUISA CHEIJ MS, LPC : TORRINGTON, CT

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General NPI Number Information
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    NPI Number           |    1124258900
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    Entity Type          |    Individual 
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    Provider Name        |    LUISA CHEIJ MS, LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/15/2009
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    Last Update Date     |    01/07/2019
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Provider Practice Location Address
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    Address Line         |    7 BRIDLE CIR 
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    City                 |    TORRINGTON
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    State                |    CT
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    Zip                  |    06790-2378
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    Country              |    US
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    Telephone            |    413-441-2074
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7 BRIDLE CIR 
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    City                 |    TORRINGTON
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    State                |    CT
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    Zip                  |    06790-2378
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    Country              |    US
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    Telephone            |    860-489-8056
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    Fax                  |    860-618-5732
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    000862
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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       |    0862
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    License Number State |    CT
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