Provider Demographics
NPI:1942601000
Name:GREENWOODS COUNSELING REFERRALS, INC.
Entity Type:Organization
Organization Name:GREENWOODS COUNSELING REFERRALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:MATTIELLO
Authorized Official - Last Name:MIASEK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-567-4437
Mailing Address - Street 1:25 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-4005
Mailing Address - Country:US
Mailing Address - Phone:860-567-4437
Mailing Address - Fax:860-567-0300
Practice Address - Street 1:25 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-4005
Practice Address - Country:US
Practice Address - Phone:860-567-4437
Practice Address - Fax:860-567-0300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8710251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health