Provider Demographics
NPI:1427571587
Name:SLC COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:SLC COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ABILDGAARD
Authorized Official - Suffix:
Authorized Official - Credentials:NCSP, LPC, NCC
Authorized Official - Phone:203-250-0305
Mailing Address - Street 1:545 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2205
Mailing Address - Country:US
Mailing Address - Phone:203-843-7434
Mailing Address - Fax:
Practice Address - Street 1:545 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2205
Practice Address - Country:US
Practice Address - Phone:203-843-7434
Practice Address - Fax:203-843-7434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002158101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty