Provider Demographics
NPI:1225758626
Name:SELF REFLECTIONS LLC
Entity Type:Organization
Organization Name:SELF REFLECTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT-NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-794-0652
Mailing Address - Street 1:600 W WOLCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-4351
Mailing Address - Country:US
Mailing Address - Phone:860-794-0652
Mailing Address - Fax:
Practice Address - Street 1:600 W WOLCOTT AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-4351
Practice Address - Country:US
Practice Address - Phone:860-794-0652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty