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General NPI Number Information
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NPI Number | 1679165070
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Entity Type | Organization
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Legal Business Name | BOX OF RAIN COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 02/07/2021
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Last Update Date | 02/07/2021
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Provider Practice Location Address
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Address Line | 43 STANLEY CT
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City | NEW BRITAIN
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State | CT
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Zip | 06051-3633
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Country | US
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Telephone | 860-839-1295
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Fax | 959-245-1856
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Provider Business Mailing Address
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Address Line | 43 STANLEY CT
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City | NEW BRITAIN
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State | CT
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Zip | 06051-3633
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Country | US
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Telephone | 860-839-1295
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Fax | 959-245-1856
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Authorized Official
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Title or Position | OWNER
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Name | DEVON LEIGH BRIEM
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Credential | LADC
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Telephone | 860-839-1295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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