Provider Demographics
NPI:1619093523
Name:CONNECTICUT COUNSELING CENTERS, INC.
Entity Type:Organization
Organization Name:CONNECTICUT COUNSELING CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BILANGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-743-4698
Mailing Address - Street 1:20 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-2656
Mailing Address - Country:US
Mailing Address - Phone:203-838-6508
Mailing Address - Fax:203-852-7021
Practice Address - Street 1:20 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-2656
Practice Address - Country:US
Practice Address - Phone:203-838-6508
Practice Address - Fax:203-852-7021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0352261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care