Provider Demographics
NPI:1104583673
Name:A CONNECTION WITHIN, LLC
Entity type:Organization
Organization Name:A CONNECTION WITHIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARINO-GOODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-333-6248
Mailing Address - Street 1:119 JENNIFER DR
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248-1412
Mailing Address - Country:US
Mailing Address - Phone:860-834-0917
Mailing Address - Fax:
Practice Address - Street 1:9 AUSTIN DR STE 109
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:CT
Practice Address - Zip Code:06447-1375
Practice Address - Country:US
Practice Address - Phone:860-333-6248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty