Provider Demographics
NPI:1275935652
Name:B&D COUNSELING SERVICES,LLC
Entity Type:Organization
Organization Name:B&D COUNSELING SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD-LOCKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-894-2384
Mailing Address - Street 1:270 MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06480-1836
Mailing Address - Country:US
Mailing Address - Phone:860-894-2384
Mailing Address - Fax:860-894-2685
Practice Address - Street 1:270 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:CT
Practice Address - Zip Code:06480-1836
Practice Address - Country:US
Practice Address - Phone:860-894-2384
Practice Address - Fax:860-894-2685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty