Provider Demographics
NPI:1346018553
Name:I WITNESS COUNSELING LLC
Entity Type:Organization
Organization Name:I WITNESS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LPC, LMHC
Authorized Official - Prefix:
Authorized Official - First Name:VIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMHC
Authorized Official - Phone:413-252-2400
Mailing Address - Street 1:1313 WOODGATE CIR
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-5591
Mailing Address - Country:US
Mailing Address - Phone:860-858-1288
Mailing Address - Fax:413-252-2443
Practice Address - Street 1:112 SPENCER ST STE 2
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4601
Practice Address - Country:US
Practice Address - Phone:203-441-3132
Practice Address - Fax:203-324-0420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health