Provider Demographics
NPI:1699224212
Name:WESTERN CT COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:WESTERN CT COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BIEBER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:475-289-2500
Mailing Address - Street 1:300 FEDERAL RD STE 209
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2412
Mailing Address - Country:US
Mailing Address - Phone:475-289-2500
Mailing Address - Fax:475-289-2501
Practice Address - Street 1:300 FEDERAL ROAD
Practice Address - Street 2:SUITE 209
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2412
Practice Address - Country:US
Practice Address - Phone:475-289-2500
Practice Address - Fax:475-289-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0066321041C0700X
CT75071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty