Provider Demographics
NPI:1598856791
Name:TRANSITIONS: A COUNSELING CENTER FOR INDIVIDUALS AND FAMILIES, LLC
Entity Type:Organization
Organization Name:TRANSITIONS: A COUNSELING CENTER FOR INDIVIDUALS AND FAMILIES, LLC
Other - Org Name:CAREY A. BEYOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEYOR
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-652-0428
Mailing Address - Street 1:78 EASTERN BOULEVARD
Mailing Address - Street 2:2ND FLOOR SUITE
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033
Mailing Address - Country:US
Mailing Address - Phone:860-652-0428
Mailing Address - Fax:860-652-0081
Practice Address - Street 1:78 EASTERN BOULEVARD
Practice Address - Street 2:2ND FLOOR SUITE
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033
Practice Address - Country:US
Practice Address - Phone:860-652-0428
Practice Address - Fax:860-652-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0063491041C0700X
CT0028711041C0700X
CT0047541041C0700X
CT000902106H00000X
CT001452106H00000X
CT001522106H00000X
CT001268106H00000X
CT001671106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008003309Medicaid
CT008003312Medicaid