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General NPI Number Information
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NPI Number | 1609296904
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Entity Type | Organization
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Legal Business Name | CARPE DIEM COUNSELING LLC
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 3 BARNARD LN SUITE 110
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City | BLOOMFIELD
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State | CT
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Zip | 06002-2452
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Country | US
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Telephone | 203-449-5399
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Fax |
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Provider Business Mailing Address
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Address Line | 113 STRATTON BROOK RD
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City | SIMSBURY
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State | CT
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Zip | 06070-2440
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Country | US
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Telephone | 203-449-5399
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CORY J BERNARD
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Credential | LCSW
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Telephone | 203-449-5399
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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 | 006662
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License Number State | CT
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