Provider Demographics
NPI:1134616279
Name:REFLECTIVE COUNSELING, LLC
Entity type:Organization
Organization Name:REFLECTIVE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:CHILD
Authorized Official - Last Name:QUERCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-576-3092
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:
Mailing Address - City:EAST WOODSTOCK
Mailing Address - State:CT
Mailing Address - Zip Code:06244-0064
Mailing Address - Country:US
Mailing Address - Phone:860-576-3092
Mailing Address - Fax:
Practice Address - Street 1:225 PROVIDENCE PIKE
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-2526
Practice Address - Country:US
Practice Address - Phone:860-576-3092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-14
Last Update Date:2018-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0094281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty