Provider Demographics
NPI:1912697418
Name:EAST COAST THERAPEUTIC CONNECTIONS PLLC
Entity Type:Organization
Organization Name:EAST COAST THERAPEUTIC CONNECTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LCAS
Authorized Official - Phone:252-229-1107
Mailing Address - Street 1:175 DOGWOOD LANDING RD
Mailing Address - Street 2:
Mailing Address - City:MERRITT
Mailing Address - State:NC
Mailing Address - Zip Code:28556-9592
Mailing Address - Country:US
Mailing Address - Phone:252-670-2073
Mailing Address - Fax:
Practice Address - Street 1:175 DOGWOOD LANDING RD
Practice Address - Street 2:
Practice Address - City:MERRITT
Practice Address - State:NC
Practice Address - Zip Code:28556-9592
Practice Address - Country:US
Practice Address - Phone:252-670-2073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty