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General NPI Number Information
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NPI Number | 1699224212
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Entity Type | Organization
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Legal Business Name | WESTERN CT COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 300 FEDERAL ROAD SUITE 209
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City | BROOKFIELD
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State | CT
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Zip | 06804-2412
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Country | US
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Telephone | 475-289-2500
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Fax | 475-289-2501
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Provider Business Mailing Address
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Address Line | 300 FEDERAL RD STE 209
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City | BROOKFIELD
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State | CT
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Zip | 06804-2412
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Country | US
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Telephone | 475-289-2500
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Fax | 475-289-2501
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | MR. DENNIS BIEBER
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Credential | LCSW
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Telephone | 475-289-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7507
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License Number State | CT
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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 | 006632
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License Number State | CT
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