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General NPI Number Information
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NPI Number | 1558386417
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Entity Type | Individual
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Provider Name | KENNETH WAYNE HARRINGTON M.ED., LPC
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 628 HEBRON AVE. 4TH FLOOR
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City | GLASTONBURY
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State | CT
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Zip | 06033
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Country | US
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Telephone | 800-638-4228
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Fax |
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Provider Business Mailing Address
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Address Line | 200 PETERSON RD
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City | POMFRET CENTER
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State | CT
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Zip | 06259
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Country | US
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Telephone | 860-974-2868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 001203
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License Number State | CT
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