Provider Demographics
NPI:1770231409
Name:SIMPLE TALKS COUNSELING LLC
Entity Type:Organization
Organization Name:SIMPLE TALKS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/LADC
Authorized Official - Phone:516-652-2100
Mailing Address - Street 1:1329 BURNSIDE AVE APT B3
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-1575
Mailing Address - Country:US
Mailing Address - Phone:516-652-2100
Mailing Address - Fax:
Practice Address - Street 1:627 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-5181
Practice Address - Country:US
Practice Address - Phone:860-324-0042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty