Provider Demographics
NPI:1225424336
Name:COUNSELING CENTER OF MONROE, LLC
Entity Type:Organization
Organization Name:COUNSELING CENTER OF MONROE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAKAL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-268-1390
Mailing Address - Street 1:PO BOX 122
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-0122
Mailing Address - Country:US
Mailing Address - Phone:203-268-1390
Mailing Address - Fax:
Practice Address - Street 1:477 MAIN ST
Practice Address - Street 2:SUITE 208
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-1139
Practice Address - Country:US
Practice Address - Phone:203-268-1390
Practice Address - Fax:203-220-2247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0066481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty