Provider Demographics
NPI:1508143819
Name:NORTHEND COUNSELING CENTER
Entity Type:Organization
Organization Name:NORTHEND COUNSELING CENTER
Other - Org Name:NORTHEND COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, MBA
Authorized Official - Phone:860-280-5489
Mailing Address - Street 1:261 BARBOUR ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06120-1705
Mailing Address - Country:US
Mailing Address - Phone:860-280-5489
Mailing Address - Fax:
Practice Address - Street 1:261 BARBOUR ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120-1705
Practice Address - Country:US
Practice Address - Phone:860-280-5489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health