Provider Demographics
NPI:1528892957
Name:CONNECTIONS FOR PSYCHOLOGICAL WELLNESS
Entity type:Organization
Organization Name:CONNECTIONS FOR PSYCHOLOGICAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:269-612-6031
Mailing Address - Street 1:125 N DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49097-1201
Mailing Address - Country:US
Mailing Address - Phone:269-612-6031
Mailing Address - Fax:269-585-6431
Practice Address - Street 1:125 N DAVIS ST
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MI
Practice Address - Zip Code:49097-1201
Practice Address - Country:US
Practice Address - Phone:269-612-6031
Practice Address - Fax:269-585-6431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty