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General NPI Number Information
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NPI Number | 1710344809
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Entity Type | Organization
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Legal Business Name | DARIEN WELLNESS
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 30 OLD KINGS HWY S
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City | DARIEN
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State | CT
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Zip | 06820-4551
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Country | US
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Telephone | 203-883-0464
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8176 # 35651
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City | GREENWICH
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State | CT
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Zip | 06836-0161
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Country | US
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Telephone | 203-883-0464
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Fax |
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Authorized Official
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Title or Position | CLIENT CARE SUPERVISOR
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Name | CIERA HAWKINS
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Credential |
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Telephone | 203-883-0464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2481
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License Number State | CT
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