Provider Demographics
NPI:1346799384
Name:BEACON FALLS COUNSELING LLC
Entity Type:Organization
Organization Name:BEACON FALLS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-729-0100
Mailing Address - Street 1:93 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEACON FALLS
Mailing Address - State:CT
Mailing Address - Zip Code:06403-1447
Mailing Address - Country:US
Mailing Address - Phone:203-729-0100
Mailing Address - Fax:
Practice Address - Street 1:93 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BEACON FALLS
Practice Address - State:CT
Practice Address - Zip Code:06403-1447
Practice Address - Country:US
Practice Address - Phone:203-729-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001260101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008024866Medicaid