Provider Demographics
NPI:1972136190
Name:STRONG FOUNDATION COUNSELING
Entity Type:Organization
Organization Name:STRONG FOUNDATION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WERTHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-239-0049
Mailing Address - Street 1:63 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-2748
Mailing Address - Country:US
Mailing Address - Phone:860-239-0049
Mailing Address - Fax:
Practice Address - Street 1:174 SOUTH RD STE 109
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4414
Practice Address - Country:US
Practice Address - Phone:860-239-0049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty