Provider Demographics
NPI:1093406951
Name:AUTHENTIC CONNECTIONS COUNSELING
Entity type:Organization
Organization Name:AUTHENTIC CONNECTIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KISS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-494-2357
Mailing Address - Street 1:1359 HANCOCK ST STE 7
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5108
Mailing Address - Country:US
Mailing Address - Phone:617-396-4483
Mailing Address - Fax:617-276-6784
Practice Address - Street 1:1359 HANCOCK ST STE 7
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5108
Practice Address - Country:US
Practice Address - Phone:617-396-4483
Practice Address - Fax:617-276-6784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-19
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty