Provider Demographics
NPI:1922388834
Name:BRIGHT BEGINNINGS COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:BRIGHT BEGINNINGS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DELAGE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-774-1841
Mailing Address - Street 1:PO BOX 571
Mailing Address - Street 2:
Mailing Address - City:DAYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06241-0571
Mailing Address - Country:US
Mailing Address - Phone:860-774-1841
Mailing Address - Fax:860-774-1841
Practice Address - Street 1:553 HARTFORD PIKE
Practice Address - Street 2:SUITE 5
Practice Address - City:DAYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06241-2150
Practice Address - Country:US
Practice Address - Phone:860-774-1841
Practice Address - Fax:860-774-1841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0067861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT273441539Medicaid