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NPI 1861302697

NPI 1861302697 : REFLECTIVE MOMENTS THERAPY LLC : NEW MILFORD, CT

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General NPI Number Information
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    NPI Number           |    1861302697
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    Entity Type          |    Organization 
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    Legal Business Name  |    REFLECTIVE MOMENTS THERAPY LLC 
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Dates
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    Enumeration Date     |    09/11/2026
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    Last Update Date     |    09/11/2026
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Provider Practice Location Address
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    Address Line         |    219 KENT RD STE 13 
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    City                 |    NEW MILFORD
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    State                |    CT
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    Zip                  |    06776-5530
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    Country              |    US
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    Telephone            |    203-645-6157
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    13 ANDERSON AVE 
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    City                 |    NEW MILFORD
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    State                |    CT
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    Zip                  |    06776-3625
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    Country              |    US
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    Telephone            |    203-645-6157
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGING MEMBER
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    Name                 |     GENA  WILLIAMSON 
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    Credential           |    LCSW
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    Telephone            |    203-645-6157
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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       |    
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    License Number State |    
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