Bright Side Counseling, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

001617 Issued in CT

Legal business name

BRIGHT SIDE COUNSELING, LLC

Practice address

122A Naubuc Ave
Suite 210
Glastonbury, CT 06033-4246

Phone

(860) 338-6706

NPI assigned

Oct 8, 2012

Last updated

Oct 8, 2012By 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

Ms. Melisa Forman, ATR, LPC

Title

Clinical Therapist/Sole Proprietor

Phone

(860) 338-6706

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1831441377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122A NAUBUC AVE",
            "address_2": "SUITE 210",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334246",
            "telephone_number": "860-338-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122A NAUBUC AVE",
            "address_2": "SUITE 210",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334246",
            "telephone_number": "860-338-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT SIDE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "FORMAN",
        "authorized_official_first_name": "MELISA",
        "authorized_official_title_or_position": "CLINICAL THERAPIST/SOLE PROPRIETOR",
        "authorized_official_telephone_number": "860-338-6706",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ATR, LPC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CT",
            "license": "001617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.