Provider Demographics
NPI: | 1912437575 |
---|---|
Name: | ALL WITHIN, LLC |
Entity type: | Organization |
Organization Name: | ALL WITHIN, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER, PSYCHOTHERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JANET |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PETERSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LCSW |
Authorized Official - Phone: | 855-937-8748 |
Mailing Address - Street 1: | 45 OLD SMITH ROAD |
Mailing Address - Street 2: | |
Mailing Address - City: | NORTHFIELD |
Mailing Address - State: | CT |
Mailing Address - Zip Code: | 06778 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 203-727-1272 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 82 MEADOW ST |
Practice Address - Street 2: | |
Practice Address - City: | LITCHFIELD |
Practice Address - State: | CT |
Practice Address - Zip Code: | 06759-3505 |
Practice Address - Country: | US |
Practice Address - Phone: | 855-937-8748 |
Practice Address - Fax: | 855-937-8748 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-06-15 |
Last Update Date: | 2017-06-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CT | 006864 | 1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Single Specialty |