Provider Demographics
NPI:1891228193
Name:THOMSON WELLNESS COUNSELING, LLC
Entity Type:Organization
Organization Name:THOMSON WELLNESS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-948-8467
Mailing Address - Street 1:843 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6020
Mailing Address - Country:US
Mailing Address - Phone:860-948-8467
Mailing Address - Fax:
Practice Address - Street 1:843 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-6020
Practice Address - Country:US
Practice Address - Phone:860-948-8467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0078341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty