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General NPI Number Information
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NPI Number | 1316557846
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Entity Type | Organization
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Legal Business Name | ANDREA QUICK COUNSELING & MEDIATION LLC
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 20 CHESTNUT ST
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City | VERNON
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State | CT
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Zip | 06066-3222
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Country | US
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Telephone | 860-938-8557
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Fax | 860-926-0064
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Provider Business Mailing Address
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Address Line | 20 CHESTNUT ST
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City | VERNON
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State | CT
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Zip | 06066-3222
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Country | US
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Telephone | 860-938-8557
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | ANDREA A QUICK
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Credential | LCSW
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Telephone | 860-938-8556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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