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NPI 1730821562

NPI 1730821562 : ACR COUNSELING LLC : NEW HAVEN, CT

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General NPI Number Information
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    NPI Number           |    1730821562
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    Entity Type          |    Organization 
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    Legal Business Name  |    ACR COUNSELING LLC 
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Dates
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    Enumeration Date     |    04/12/2022
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    Last Update Date     |    04/12/2022
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Provider Practice Location Address
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    Address Line         |    31 ARTIZAN ST 
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    City                 |    NEW HAVEN
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    State                |    CT
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    Zip                  |    06511-4901
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    Country              |    US
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    Telephone            |    203-859-8708
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    31 ARTIZAN ST 
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    City                 |    NEW HAVEN
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    State                |    CT
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    Zip                  |    06511-4901
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    Country              |    US
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    Telephone            |    203-859-8708
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    Fax                  |    
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Authorized Official
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    Title or Position    |    THERAPIST
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    Name                 |    MS. AMANDA  PAGE 
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    Credential           |    MA, LMHC
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    Telephone            |    978-855-0710
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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       |    
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    License Number State |    
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