Life'S Journey Counseling LLC
Organization Active NPI Counselor · Griswold, CT
NPI 1285239228 · NPPES record last updated Dec 4, 2020
Key facts
- NPI
- 1285239228
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- Legal business name
- LIFE'S JOURNEY COUNSELING LLC
- Practice address
- 70 Main St
Griswold, CT 06351-2226 - Phone
- (860) 634-0967
- NPI assigned
- Nov 30, 2020
- Organization subpart
- No
Authorized official
- Name
- Nicholas Gaughan, LPC/LADC
- Title
- Owner
- Phone
- (860) 634-0967
Practitioners 6
-
Nicholas Gaughan, LPC
-
Timothy B Cormier, L.P.C.
-
Nicole Marie Hayes, LPC, LMHC
-
Richard J. Conover, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240521000080 | CT | Part B Supplier - Clinic/Group Practice | 6507208758 |
Receives reassigned benefits from 6 practitioners Practice locations: Jewett City, CT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | Yes | ||
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Mental Health Counselor |
101YM0800X |
Addresses
Primary practice location
70 Main St
Griswold, CT 06351-2226
Mailing address
PO Box 296
Rogers, CT 06263-0296
Phone (860) 634-0967
Other providers in Griswold, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.