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General NPI Number Information
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NPI Number | 1982132718
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Entity Type | Organization
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Legal Business Name | SUPPORT THROUGHOUT THE JOURNEY, LLC
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Dates
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Enumeration Date | 05/24/2017
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Last Update Date | 05/24/2017
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Provider Practice Location Address
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Address Line | 238 MONROE TPKE UNIT B
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City | MONROE
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State | CT
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Zip | 06468-6200
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Country | US
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Telephone | 203-414-5393
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Fax |
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Provider Business Mailing Address
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Address Line | 775 CHICKADEE LN
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City | STRATFORD
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State | CT
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Zip | 06614-2479
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Country | US
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Telephone | 203-414-5393
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | MRS. THERESA A MONTELLI-CAVOTO
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Credential | LCSW
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Telephone | 203-414-5393
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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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