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General NPI Number Information
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NPI Number | 1225358963
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Entity Type | Organization
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Legal Business Name | COLLABORATIVE COUNSELING LLC
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 246 WOLCOTT RD.
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City | WOLCOTT
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State | CT
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Zip | 06716
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Country | US
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Telephone | 203-879-4424
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Fax | 203-879-4442
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Provider Business Mailing Address
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Address Line | PO BOX 453 BRISTOL, CT 06011
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City | BRISTOL
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State | CT
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Zip | 06011
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Country | US
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Telephone | 203-879-4424
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Fax | 203-879-4442
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. LORI B KUNTZ
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Credential | LMFT
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Telephone | 860-977-7260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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