Provider Demographics
NPI:1306152517
Name:QUIET CORNER COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:QUIET CORNER COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FRECHETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-315-9025
Mailing Address - Street 1:96 FRONT ST STE B
Mailing Address - Street 2:PO BOX 664
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260-1643
Mailing Address - Country:US
Mailing Address - Phone:860-315-9025
Mailing Address - Fax:866-212-7223
Practice Address - Street 1:96 FRONT ST STE B
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-1643
Practice Address - Country:US
Practice Address - Phone:860-315-9025
Practice Address - Fax:866-212-7223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0062101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty