Provider Demographics
NPI:1679220842
Name:AMY SEDGWICK COUNSELING LLC
Entity Type:Organization
Organization Name:AMY SEDGWICK COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDGWICK
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:860-940-1101
Mailing Address - Street 1:196 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06787-1057
Mailing Address - Country:US
Mailing Address - Phone:860-940-1101
Mailing Address - Fax:
Practice Address - Street 1:486 S MAIN ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1844
Practice Address - Country:US
Practice Address - Phone:860-940-1101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty