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General NPI Number Information
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NPI Number | 1639565120
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Entity Type | Organization
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Legal Business Name | CONNECTIONS COUNSELING PSYCHOTHERAPY LCSW PLLC
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Dates
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Enumeration Date | 04/10/2015
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 6 DUZINE RD
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City | NEW PALTZ
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State | NY
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Zip | 12561-1304
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Country | US
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Telephone | 845-255-5022
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Fax | 845-943-6757
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Provider Business Mailing Address
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Address Line | 41 MAIN ST UNIT 1235
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City | NEW PALTZ
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State | NY
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Zip | 12561-9838
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Country | US
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Telephone | 845-255-5022
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Fax | 845-943-6757
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Authorized Official
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Title or Position | MANAGING MEMBER/OWNER
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Name | DR. RUTH LIN CAMPBELL
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Credential | PH.D.
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Telephone | 845-255-5022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 044725
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License Number State | NY
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