Provider Demographics
NPI:1326529850
Name:TRUE NORTH COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:TRUE NORTH COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILLENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERTOLINI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-532-0099
Mailing Address - Street 1:8 NOVELTY LN STE 2
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:CT
Mailing Address - Zip Code:06426-1168
Mailing Address - Country:US
Mailing Address - Phone:860-532-0099
Mailing Address - Fax:860-879-3052
Practice Address - Street 1:8 NOVELTY LN STE 2
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:CT
Practice Address - Zip Code:06426-1168
Practice Address - Country:US
Practice Address - Phone:860-532-0099
Practice Address - Fax:860-879-3052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001398251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)