Provider Demographics
NPI:1699307686
Name:CT RESILIENCY COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:CT RESILIENCY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:BISSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-919-0362
Mailing Address - Street 1:175 CAPITAL BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 CAPITAL BLVD STE 402
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3914
Practice Address - Country:US
Practice Address - Phone:860-919-0362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)