Old Lyme Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

OLD LYME COUNSELING, LLC

Practice address

4 Davis Rd W
Suite 6
Old Lyme, CT 06371-4408

Phone

(860) 617-4082

NPI assigned

Mar 23, 2010

Last updated

Sep 27, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Heather Bonitz Moore, MS, ATR-BC, LPCNPI 1821165788

Title

Part Owner

Phone

(860) 617-4082

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heather Jo Bonitz-Moore, ATR-BC, LPC, IMH-E

  • Professional Counselor
  • Bozrah, CT
  • NPI 1821165788
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285545600000",
    "number": "1083938872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BEECHWOOD BLVD",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063601405",
            "telephone_number": "860-617-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 DAVIS RD W",
            "address_2": "SUITE 6",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063714408",
            "telephone_number": "860-617-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD LYME COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-09-27",
        "status": "A",
        "authorized_official_last_name": "BONITZ MOORE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "860-617-4082",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, ATR-BC, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Cirilli Nutrition LLC
• Northeast Plastic Surgery Center LLC
• Kara Zaneski O'Connor
• Sabine O'Donnell, MA LMFT
• Olaf Johan Ogland, MD
• Old Lyme Dental Associates LLC
• Old Lyme South End Volunteer Ambulance
• Tracie Ortoleva, OTR
• Evelyn Darlene Ososkie, LMFT
• Susan M Ostrowski, MA CCC-SLP

• Community/Behavioral Health Agency in Old Lyme, CT
• Providers in Old Lyme, CT by specialty
• Community/Behavioral Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.