Provider Demographics
NPI:1063846277
Name:GREENWOODS COUNSELING REFERRALS, INC.
Entity Type:Organization
Organization Name:GREENWOODS COUNSELING REFERRALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-567-7724
Mailing Address - Street 1:PO BOX 1549
Mailing Address - Street 2:21 SOUTH STREET
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-1549
Mailing Address - Country:US
Mailing Address - Phone:860-567-7724
Mailing Address - Fax:860-567-0300
Practice Address - Street 1:25 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-4005
Practice Address - Country:US
Practice Address - Phone:860-567-7724
Practice Address - Fax:860-567-0300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-23
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000840103TC0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty