Provider Demographics
NPI:1770151748
Name:CAUSEWAY COLLABORATIVE LLC
Entity type:Organization
Organization Name:CAUSEWAY COLLABORATIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BENEVENTO
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-927-3713
Mailing Address - Street 1:1465 POST RD E STE 201
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5528
Mailing Address - Country:US
Mailing Address - Phone:203-255-0301
Mailing Address - Fax:
Practice Address - Street 1:1465 POST RD E STE 201
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5528
Practice Address - Country:US
Practice Address - Phone:203-255-0301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty