Provider Demographics
NPI:1689960551
Name:STAMFORD COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:STAMFORD COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:STANEK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-323-8560
Mailing Address - Street 1:1 WALTON PL
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-1522
Mailing Address - Country:US
Mailing Address - Phone:203-323-8560
Mailing Address - Fax:203-323-9937
Practice Address - Street 1:1 WALTON PL
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-1522
Practice Address - Country:US
Practice Address - Phone:203-323-8560
Practice Address - Fax:203-323-9937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health