Provider Demographics
NPI:1356824502
Name:THOMASTON COUNSELING CENTER
Entity type:Organization
Organization Name:THOMASTON COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/ADMIN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERMIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-880-0677
Mailing Address - Street 1:258 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06787-1815
Mailing Address - Country:US
Mailing Address - Phone:860-880-0677
Mailing Address - Fax:
Practice Address - Street 1:258 S MAIN ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1815
Practice Address - Country:US
Practice Address - Phone:860-880-0677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty