Provider Demographics
NPI:1588195192
Name:POSITIVE MIND COUNSELING
Entity Type:Organization
Organization Name:POSITIVE MIND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIVATE CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MEGHANN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:413-847-1404
Mailing Address - Street 1:225 PROVIDENCE PIKE
Mailing Address - Street 2:
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260-2526
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 PROVIDENCE PIKE
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-2526
Practice Address - Country:US
Practice Address - Phone:413-847-1404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0077561041C0700X
CT001722106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty