Provider Demographics
NPI:1164844320
Name:KT COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:KT COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:TASSINARI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-270-7070
Mailing Address - Street 1:84 S MAIN ST
Mailing Address - Street 2:BLDG C
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2356
Mailing Address - Country:US
Mailing Address - Phone:203-270-7070
Mailing Address - Fax:
Practice Address - Street 1:84 S MAIN ST
Practice Address - Street 2:BLDG C
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-2356
Practice Address - Country:US
Practice Address - Phone:203-270-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001945251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health