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General NPI Number Information
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NPI Number | 1912313008
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Entity Type | Organization
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Legal Business Name | REFLECTIONS OF CHESTER, HEALTH & WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 19 N MAIN ST
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City | CHESTER
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State | CT
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Zip | 06412-1201
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Country | US
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Telephone | 860-526-4212
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Fax | 860-526-2203
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Provider Business Mailing Address
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Address Line | 19 N MAIN ST
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City | CHESTER
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State | CT
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Zip | 06412-1201
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Country | US
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Telephone | 860-526-4212
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Fax | 860-526-2203
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Authorized Official
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Title or Position | OWNER
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Name | JUDY SPLITTGERBER
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Credential | APRN
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Telephone | 860-526-4212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001047
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 001047
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 001047
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 001047
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 001047
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License Number State | CT
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Taxonomy #6
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 001047
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License Number State | CT
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