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General NPI Number Information
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NPI Number | 1194271999
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Entity Type | Organization
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Legal Business Name | ACHIEVE WELLNESS, LLC
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Dates
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Enumeration Date | 08/31/2016
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 236 BOSTON POST RD SUITE 8
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City | ORANGE
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State | CT
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Zip | 06477-3236
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Country | US
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Telephone | 203-767-9966
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Fax |
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Provider Business Mailing Address
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Address Line | 68 HALL DR
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City | ORANGE
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State | CT
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Zip | 06477-2543
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Country | US
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Telephone | 203-767-9966
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | MS. MEAGAN L SCOTT
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Credential | LCSW
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Telephone | 203-767-9966
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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 | 008184
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License Number State | CT
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