Provider Demographics
NPI:1336485812
Name:INTERLOCKING CONNECTIONS, LLC
Entity Type:Organization
Organization Name:INTERLOCKING CONNECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:KULPA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-745-7144
Mailing Address - Street 1:707 ENFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-2903
Mailing Address - Country:US
Mailing Address - Phone:860-745-7144
Mailing Address - Fax:
Practice Address - Street 1:707 ENFIELD ST
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-2903
Practice Address - Country:US
Practice Address - Phone:860-745-7144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001570251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health