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General NPI Number Information
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NPI Number | 1457848533
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Entity Type | Organization
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Legal Business Name | ALLISON TARDIF COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 04/16/2018
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 642 HILLIARD ST STE 1213
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City | MANCHESTER
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State | CT
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Zip | 06042-2700
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Country | US
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Telephone | 860-918-8802
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Fax |
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Provider Business Mailing Address
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Address Line | 642 HILLIARD ST STE 1213
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City | MANCHESTER
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State | CT
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Zip | 06042-2700
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Country | US
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Telephone | 860-918-8802
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | ALLISON TARDIF
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Credential | ATR-BC, LPC, CLAT
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Telephone | 860-918-8802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 003174
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License Number State | CT
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