Provider Demographics
NPI:1114663200
Name:FLOWING RIVER COUNSELING, LLC
Entity Type:Organization
Organization Name:FLOWING RIVER COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:EVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORUJO-AIRD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-506-5200
Mailing Address - Street 1:51 DEPOT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-2667
Mailing Address - Country:US
Mailing Address - Phone:860-506-5200
Mailing Address - Fax:860-506-5272
Practice Address - Street 1:51 DEPOT ST STE 202
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2667
Practice Address - Country:US
Practice Address - Phone:860-506-5200
Practice Address - Fax:860-506-5272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty