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NPI Code Detail

MEDICARE: STEPHANIE RICH, LLC

MEDICARE: STEPHANIE RICH, LLC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor882CT
2101YM0800XMental Health Counselor001448CT

General Provider Information

NPI Number : 1720380819
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEPHANIE RICH, LLC
Provider Business Mailing Address
First Line : PO BOX 216
Second Line :
City : SHERMAN
State : CT
Zip : 06784-0216
Country : US
Telephone Number : 203-313-1801
Fax Number : 253-645-7724
Provider Business Practice Location Address
First Line : 4 MAIN ST
Second Line :
City : NEW MILFORD
State : CT
Zip : 06776-2802
Country : US
Telephone Number : 203-313-1801
Fax Number : 253-645-7724
Authorized Official
Title or Position : COUNSELOR
Name : MRS. STEPHANIE L. RICH
Credential : LPC, LADC
Telephone Number : 203-313-1801
Provider Enumeration Date : 11/23/2010
Last Update Date : 11/23/2010

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