Provider Demographics
NPI:1447734777
Name:A SUPPORTIVE SOLUTION, LLC
Entity Type:Organization
Organization Name:A SUPPORTIVE SOLUTION, LLC
Other - Org Name:ELIZABETH BIBEAULT, LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:LALIBERTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-572-3600
Mailing Address - Street 1:37 BRIDGEPORT AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3940
Mailing Address - Country:US
Mailing Address - Phone:203-572-3600
Mailing Address - Fax:
Practice Address - Street 1:37 BRIDGEPORT AVE FL 2
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3940
Practice Address - Country:US
Practice Address - Phone:203-572-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health