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General NPI Number Information
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NPI Number | 1962116665
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Entity Type | Organization
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Legal Business Name | ESSENTIAL SERVICES, LLC
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 4 MERRIGAN LANE
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City | WINDSOR LOCKS
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State | CT
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Zip | 06096
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Country | US
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Telephone | 860-461-6681
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 139
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City | WINDSOR LOCKS
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State | CT
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Zip | 06096
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Country | US
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Telephone | 860-461-6681
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Fax |
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | MR. DENNIS KOFI KONADU
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Credential | LCSW, LADC
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Telephone | 860-461-6681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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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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