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General NPI Number Information
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NPI Number | 1386969582
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Entity Type | Organization
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Legal Business Name | LITCHFIELD HILLS CHILD COUNSELING, LLC
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Dates
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Enumeration Date | 03/30/2010
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 16 SOUTH ST
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City | LITCHFIELD
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State | CT
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Zip | 06759-9998
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Country | US
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Telephone | 860-567-0215
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Fax |
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Provider Business Mailing Address
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Address Line | 16 SOUTH ST PO BOX 669
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City | LITCHFIELD
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State | CT
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Zip | 06759-9998
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Country | US
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Telephone | 860-567-0215
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ANNE SMITH
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Credential | PH.D.
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Telephone | 860-567-0215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 002780
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License Number State | CT
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