Provider Demographics
NPI:1063908507
Name:GIRARD COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:GIRARD COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:GIRARD
Authorized Official - Suffix:II
Authorized Official - Credentials:LMSW, LADC
Authorized Official - Phone:203-423-3546
Mailing Address - Street 1:405 BIOSKI RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-3619
Mailing Address - Country:US
Mailing Address - Phone:203-423-3546
Mailing Address - Fax:
Practice Address - Street 1:182 GRAND ST STE 219
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1914
Practice Address - Country:US
Practice Address - Phone:203-423-3546
Practice Address - Fax:203-841-1184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1206251S00000X, 101YA0400X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty