Blue Water Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLUE WATER COUNSELING LLC

Practice address

2 Quarry Hill Rd
Killingworth, CT 06419-2230

Phone

(860) 510-2301

NPI assigned

Sep 18, 2023

Last updated

Sep 18, 2023By 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

Kelly A Leach, LCSW

Title

Owner

Phone

(860) 510-2301

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1720866148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 QUARRY HILL RD",
            "city": "KILLINGWORTH",
            "state": "CT",
            "postal_code": "064192230",
            "telephone_number": "860-510-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 QUARRY HILL RD",
            "city": "KILLINGWORTH",
            "state": "CT",
            "postal_code": "064192230",
            "telephone_number": "860-510-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-510-2301",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Amato
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• Thomas Joseph Applegate, SOCIAL WORKER
• Alia Barefoot
• Beth Zukowski
• Avery Caroline Broderick
• Kelsey Ann Kearns Buttendorf
• Maria Caponetti, LMSW
• Clara Elizabeth Chasse, LCSW
• Robert Roy Clark, PH.D.

• Clinical Social Worker in Killingworth, CT
• Providers in Killingworth, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.