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General NPI Number Information
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NPI Number | 1992268270
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Entity Type | Organization
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Legal Business Name | CONNECTING THE DOTS THERAPY, LLC
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 3823 HIGHWAY 80 E STE 600
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City | PEARL
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State | MS
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Zip | 39208-4278
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Country | US
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Telephone | 769-524-4305
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Fax | 769-524-4321
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Provider Business Mailing Address
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Address Line | PO BOX 54475
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City | PEARL
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State | MS
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Zip | 39288-4475
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Country | US
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Telephone | 769-524-4305
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Fax | 769-524-4321
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | JONATHAN ONEAL WINSTON
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Credential | MSW, LCSW
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Telephone | 769-524-4305
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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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