Provider Demographics
NPI:1033428164
Name:CHILDREN 1ST COUNSELING SERVICES
Entity Type:Organization
Organization Name:CHILDREN 1ST COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-916-6996
Mailing Address - Street 1:3 BARNARD LANE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2452
Mailing Address - Country:US
Mailing Address - Phone:860-916-6996
Mailing Address - Fax:860-726-9191
Practice Address - Street 1:3 BARNARD LANE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2452
Practice Address - Country:US
Practice Address - Phone:860-916-6996
Practice Address - Fax:860-726-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001013101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty