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General NPI Number Information
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NPI Number | 1366786063
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Entity Type | Organization
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Legal Business Name | CREATING CONNECTIONS TOGETHER, LCSW, PLLC
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 11/19/2012
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Provider Practice Location Address
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Address Line | 19 ROSE ST
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City | POUGHQUAG
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State | NY
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Zip | 12570-5733
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Country | US
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Telephone | 845-227-6574
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Fax | 845-227-7450
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Provider Business Mailing Address
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Address Line | 19 ROSE ST
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City | POUGHQUAG
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State | NY
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Zip | 12570-5733
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Country | US
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Telephone | 845-227-6574
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Fax | 845-227-7450
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | JOANN MAZZOCCHI-FLEITZ
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Credential | LCSW-R
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Telephone | 845-227-6574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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