Provider Demographics
NPI:1518582774
Name:PEACEFUL RESOLUTION
Entity Type:Organization
Organization Name:PEACEFUL RESOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CRISTAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAWTHORNE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:347-207-1110
Mailing Address - Street 1:1317 EAST ST APT 110
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-2566
Mailing Address - Country:US
Mailing Address - Phone:347-207-1110
Mailing Address - Fax:
Practice Address - Street 1:1317 EAST ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-2565
Practice Address - Country:US
Practice Address - Phone:347-207-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty