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Organization
LIFE STAGES COUNSELING CENTER, INC
Active
Organization
LIFE STAGES COUNSELING CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESA GRELLA HILLEBRAND LMFT (LICENSED FAMILY THERAPIST/PARTNER)
(516) 617-2635
Entity
Organization
Contact information
Practice address
14 CANDLEWOOD PATH, DIX HILLS, NY 11746-5304
(516) 617-2635
(631) 462-6499
Mailing address
14 CANDLEWOOD PATH, DIX HILLS, NY 11746-5304
(516) 617-2635
(631) 462-6499
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6464
NY
1041C0700X
Clinical Social Worker
Primary
074243-1
NY
106H00000X
Marriage & Family Therapist
000155-1
NY
Other
Enumeration date
03/21/2007
Last updated
06/05/2008
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