Provider Demographics
NPI:1396413829
Name:LOOKING GLASS THERAPY LLC
Entity Type:Organization
Organization Name:LOOKING GLASS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHERA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-300-7687
Mailing Address - Street 1:2 KLARIDES VILLAGE DR UNIT 272
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:CT
Mailing Address - Zip Code:06483-2737
Mailing Address - Country:US
Mailing Address - Phone:203-300-7687
Mailing Address - Fax:
Practice Address - Street 1:2 KLARIDES VILLAGE DR UNIT 272
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:CT
Practice Address - Zip Code:06483-2737
Practice Address - Country:US
Practice Address - Phone:475-222-9121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty