Provider Demographics
NPI:1003230012
Name:ONE PIECE OF THE PUZZLE, LLC
Entity Type:Organization
Organization Name:ONE PIECE OF THE PUZZLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:KROM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-919-6956
Mailing Address - Street 1:122 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-4109
Mailing Address - Country:US
Mailing Address - Phone:860-919-6956
Mailing Address - Fax:860-904-2839
Practice Address - Street 1:460 SMITH ST
Practice Address - Street 2:SUITE L
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-1594
Practice Address - Country:US
Practice Address - Phone:860-990-0776
Practice Address - Fax:860-904-2839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002118251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health