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General NPI Number Information
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NPI Number | 1821864984
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Entity Type | Organization
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Legal Business Name | EARLY CHILDHOOD SERVICES OF CT, PLLC
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Dates
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Enumeration Date | 11/29/2023
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 49 LOCUST AVE STE 103
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City | NEW CANAAN
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State | CT
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Zip | 06840-4764
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Country | US
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Telephone | 203-293-2590
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Fax |
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Provider Business Mailing Address
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Address Line | 89 SADDLE HILL RD
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City | STAMFORD
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State | CT
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Zip | 06903-2308
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | GEORGETTE HARRISON
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Credential | LPC
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Telephone | 203-293-2590
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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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