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General NPI Number Information
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NPI Number | 1225424336
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Entity Type | Organization
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Legal Business Name | COUNSELING CENTER OF MONROE, LLC
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 05/04/2020
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Provider Practice Location Address
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Address Line | 477 MAIN ST SUITE 208
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City | MONROE
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State | CT
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Zip | 06468-1139
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Country | US
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Telephone | 203-268-1390
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Fax | 203-220-2247
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Provider Business Mailing Address
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Address Line | PO BOX 122
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City | MONROE
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State | CT
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Zip | 06468-0122
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Country | US
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Telephone | 203-268-1390
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Fax |
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Authorized Official
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Title or Position | OWNER/SOLE PROVIDER
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Name | MS. DEBORAH A SAKAL
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Credential | LCSW
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Telephone | 203-268-1390
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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 | 006648
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License Number State | CT
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