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General NPI Number Information
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NPI Number | 1932806759
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Entity Type | Organization
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Legal Business Name | ROOM TO GROW COUNSELING
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 915 SULLIVAN AVE
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-2164
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Country | US
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Telephone | 860-681-1866
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Fax |
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Provider Business Mailing Address
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Address Line | 6 RIVER BEND LN
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City | WINDSOR
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State | CT
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Zip | 06095-1617
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Country | US
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Telephone | 860-681-1866
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA SEGAL
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Credential | LCSW
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Telephone | 860-681-1866
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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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