MEDICARE: POSITIVE DIRECTIONS - THE CENTER FOR PREVENTION AND COUNSELING INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	251S00000X	Community/Behavioral Health Agency	SA-0140	CT
3	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598900524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVE DIRECTIONS - THE CENTER FOR PREVENTION AND COUNSELING INC

Provider Business Mailing Address
First Line	:	90 POST RD W
Second Line	:
City	:	WESTPORT
State	:	CT
Zip	:	06880-4208
Country	:	US
Telephone Number	:	203-227-7644
Fax Number	:	203-227-0037

Provider Business Practice Location Address
First Line	:	90 POST RD W
Second Line	:
City	:	WESTPORT
State	:	CT
Zip	:	06880-4208
Country	:	US
Telephone Number	:	203-227-7644
Fax Number	:	203-227-0037

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JENNIFER LYNN HRBEK
Credential	:	LCSW
Telephone Number	:	203-227-7644

Provider Enumeration Date	:	12/04/2008
Last Update Date	:	10/31/2018

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