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General NPI Number Information
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NPI Number | 1306580519
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Entity Type | Organization
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Legal Business Name | TUS NUA COUNSELING LLC
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Dates
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Enumeration Date | 04/24/2022
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Last Update Date | 04/24/2022
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Provider Practice Location Address
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Address Line | 44 DALE RD STE 303
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City | AVON
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State | CT
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Zip | 06001-4351
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Country | US
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Telephone | 620-407-7290
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 565
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City | GRANBY
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State | CT
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Zip | 06035-0565
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Country | US
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Telephone | 860-729-6652
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DOUGLAS J LAMPERT
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Credential | LPC
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Telephone | 860-729-6652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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