Partners in Counseling LLC
Organization Active NPI Addiction (Substance Use Disorder) Counselor · North Windham, CT
NPI 1316197965 · NPPES record last updated Oct 5, 2014
Key facts
- NPI
- 1316197965
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 000055 (CT)
- Legal business name
- PARTNERS IN COUNSELING LLC
- Practice address
- 387 Tuckie Rd
Suite D
North Windham, CT 06256-1355 - Phone
- (860) 423-4279
- Fax
- (860) 423-4284
- NPI assigned
- Sep 19, 2008
- Organization subpart
- No
Authorized official
- Name
- Mrs. Marianne R. Carroll, MA,LADC
- Title
- Manager
- Phone
- (860) 423-4279
Practitioners 2
-
Timothy Kevin Carroll, LCSW
-
Marianne Roberts Carroll, MA LADC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121121000101 | CT | Part B Supplier - Clinic/Group Practice | 0840441861 |
Receives reassigned benefits from 1 practitioner Practice locations: North Windham, CT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | 000055 | CT | Yes |
| Clinical Social Worker |
1041C0700X | 003025 | CT | |
| Community/Behavioral Health Agency | 251S00000X | 003025 | CT |
Addresses
Primary practice location
387 Tuckie Rd
Suite D
North Windham, CT 06256-1355
Mailing address
387 Tuckie Rd
Suite D
North Windham, CT 06256-1355
Phone (860) 423-4279
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004165397 | Medicaid | CT |
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All providers in North Windham, CT · Addiction (Substance Use Disorder) Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2014. 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.