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General NPI Number Information
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NPI Number | 1851802474
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Entity Type | Organization
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Legal Business Name | EMPATHIC CARE COUNSELING LLC
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 357 EAST CENTER STREET
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City | MANCHESTER
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State | CT
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Zip | 06108
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Country | US
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Telephone | 860-380-7228
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Fax |
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Provider Business Mailing Address
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Address Line | 357 E CENTER ST
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City | MANCHESTER
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State | CT
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Zip | 06040-4472
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Country | US
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Telephone | 860-380-7228
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | MS. DIANE M BLACKWOOD
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Credential | LADC
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Telephone | 860-380-7228
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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 | 1239
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License Number State | CT
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