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General NPI Number Information
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NPI Number | 1669307294
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Entity Type | Organization
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Legal Business Name | THE UNFOLDING SPACE, LLC
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 246 FEDERAL RD STE D22
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City | BROOKFIELD
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State | CT
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Zip | 06804-2650
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Country | US
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Telephone | 203-915-9708
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Fax |
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Provider Business Mailing Address
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Address Line | 2389 MAIN ST STE 100
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City | GLASTONBURY
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State | CT
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Zip | 06033-4617
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Country | US
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Telephone | 203-915-9708
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. VIVIANA O CROWELL
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Credential | LCSW
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Telephone | 203-915-9708
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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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