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General NPI Number Information
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NPI Number | 1881350064
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Entity Type | Organization
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Legal Business Name | CARREFOUR COUNSELING LLC
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Dates
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Enumeration Date | 11/12/2021
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 900 STRAITS TPKE STE 205R
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City | MIDDLEBURY
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State | CT
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Zip | 06762-2865
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Country | US
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Telephone | 502-617-1511
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Fax |
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Provider Business Mailing Address
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Address Line | 115 LAKE PL S
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City | DANBURY
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State | CT
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Zip | 06810-7259
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Country | US
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Telephone | 502-617-1511
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | CATHERINE L MCLEAN
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Credential |
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Telephone | 502-617-1511
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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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