Provider Demographics
NPI:1104534957
Name:NIA COUNSELING & CONSULTING SERVICES, LLC
Entity type:Organization
Organization Name:NIA COUNSELING & CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMESHA
Authorized Official - Middle Name:CHANTE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD CANDIDATE, LCSW
Authorized Official - Phone:860-936-8302
Mailing Address - Street 1:642 HILLIARD ST STE 1310
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-2700
Mailing Address - Country:US
Mailing Address - Phone:860-936-8302
Mailing Address - Fax:
Practice Address - Street 1:642 HILLIARD ST STE 1310
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-2700
Practice Address - Country:US
Practice Address - Phone:860-936-8302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty