Provider Demographics
NPI:1093498487
Name:LAUREL COUNSELING & COACHING LLC
Entity Type:Organization
Organization Name:LAUREL COUNSELING & COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:LAUR
Authorized Official - Last Name:FERENCE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-581-0544
Mailing Address - Street 1:51 BROADWAY APT 3
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-6060
Mailing Address - Country:US
Mailing Address - Phone:203-581-0544
Mailing Address - Fax:
Practice Address - Street 1:84 ALMA DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-2966
Practice Address - Country:US
Practice Address - Phone:203-581-0544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)