Authentic Balance Consortium LLC
Organization Active NPI Professional Counselor · Chaplin, CT
NPI 1538347349 · NPPES record last updated Feb 4, 2008
Key facts
- NPI
- 1538347349
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 001484 (CT)
- Legal business name
- AUTHENTIC BALANCE CONSORTIUM LLC
- Practice address
- 267 Willimantic Rd
Suite 5
Chaplin, CT 06235-2516 - Phone
- (860) 617-2848
- NPI assigned
- Feb 4, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Diane Tarricone, LPC
- Title
- Partner
- Phone
- (860) 617-2848
Practitioners 1
-
Jara J Messere, LCSW
National Provider Directory
Locations
267 Willimantic Rd
Ste 5
Chaplin, CT 06235
Phone (860) 455-9812
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | 001484 | CT | Yes |
| Clinical Social Worker |
1041C0700X | 006609 | CT |
Addresses
Primary practice location
267 Willimantic Rd
Suite 5
Chaplin, CT 06235-2516
Mailing address
267 Willimantic Rd
Suite 5
Chaplin, CT 06235-2516
Phone (860) 617-2848
Other providers in Chaplin, CT
- Kelsey Ann Mahoney Butcka
- Chaplin Public Schools
- Elizabeth H Flanagan
- Bert Dennis Gunn
- Interior Castle Counseling, LLC
All providers in Chaplin, CT · Professional 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 Feb 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.