Provider Demographics
NPI:1396472460
Name:COMPASSIONATE COUCH COUNSELING SERVICES
Entity type:Organization
Organization Name:COMPASSIONATE COUCH COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THARRRARA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MUSE-BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-213-3242
Mailing Address - Street 1:279 BRIDGE ST UNIT 12
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-3778
Mailing Address - Country:US
Mailing Address - Phone:860-213-3242
Mailing Address - Fax:
Practice Address - Street 1:554 LONG HILL RD STE 9
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-4170
Practice Address - Country:US
Practice Address - Phone:860-213-3242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty