| NPI | 1306699244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY G. NICHOLS Owner 203-509-5510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2024-08-26 |