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General NPI Number Information
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NPI Number | 1295103067
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Entity Type | Organization
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Legal Business Name | J.C. COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 43 SHERMAN HILL RD BLDG D, SUITE 201B
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City | WOODBURY
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State | CT
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Zip | 06798-3651
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Country | US
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Telephone | 203-980-3850
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Fax | 203-596-0757
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Provider Business Mailing Address
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Address Line | PO BOX 1064
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City | WATERBURY
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State | CT
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Zip | 06721-1064
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Country | US
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Telephone | 203-980-3850
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Fax | 203-596-0757
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY RINKO
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Credential | LCSW
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Telephone | 203-980-3850
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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 | 8307
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License Number State | CT
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