Provider Demographics
NPI:1720596984
Name:TM COUNSELING & RECOVERY SERVICES, LLC
Entity Type:Organization
Organization Name:TM COUNSELING & RECOVERY SERVICES, LLC
Other - Org Name:NEW ENGLAND FAMILY WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-913-0281
Mailing Address - Street 1:415 BOSTON POST RD STE 3-515
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-2578
Mailing Address - Country:US
Mailing Address - Phone:203-913-0281
Mailing Address - Fax:
Practice Address - Street 1:415 BOSTON POST RD STE 3-515
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-2578
Practice Address - Country:US
Practice Address - Phone:203-913-0281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001210101YA0400X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT6496OtherPROFESSIONAL COUNSELOR