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General NPI Number Information
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NPI Number | 1437627908
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Entity Type | Organization
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Legal Business Name | CONNECTING TO GREATNESS LLC
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Dates
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Enumeration Date | 11/02/2018
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 27 MONUMENT SQ STE 100
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City | LEOMINSTER
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State | MA
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Zip | 01453-5769
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Country | US
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Telephone | 978-516-4600
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Fax | 978-516-4601
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Provider Business Mailing Address
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Address Line | PO BOX 1417
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City | LEOMINSTER
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State | MA
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Zip | 01453-8417
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIMATRA MAXWELL
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Credential | LICSW
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Telephone | 978-602-4913
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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 |
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License Number State |
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