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General NPI Number Information
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NPI Number | 1457018343
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR CONNECTION AND CHANGE LLC
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Dates
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Enumeration Date | 11/26/2021
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Last Update Date | 11/26/2021
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Provider Practice Location Address
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Address Line | 44 KNEEN ST
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City | SHELTON
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State | CT
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Zip | 06484-3912
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Country | US
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Telephone | 203-856-4449
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Fax |
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Provider Business Mailing Address
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Address Line | 1371 BOSTON POST RD # 1022
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City | MILFORD
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State | CT
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Zip | 06460-2755
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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 | MANAGER
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Name | LYDIA KRENICKI
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Credential | LMFT
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Telephone | 203-856-4449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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