NPI 1124584982 · live from the CMS NPI Registry
A Tree Of Life Counseling Center
Social Worker, Clinical in Bloomfield, CT. National Provider Identifier 1124584982, active.
NPI record
| NPI | 1124584982 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 3 Barnard Ln Ste 310, Bloomfield, CT 06002 |
| Practice phone | 860-455-3384 |
| Mailing address | 10 Miller Rd, East Granby, CT 06026 |
| Enumerated | February 18, 2019 |
| Last updated | June 11, 2019 |
| Authorized official | Kristen Larson-Samalus, Owner/Director |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.