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Organization
GREY STREET COUNSELING CENTER LLC
Active
Organization
GREY STREET COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA WALLACE LPC (OWNER)
(203) 441-7557
Entity
Organization
Contact information
Practice address
504 WOLCOTT RD STE D, WOLCOTT, CT 06716-2462
(203) 441-7557
Mailing address
504 WOLCOTT RD STE D, WOLCOTT, CT 06716-2462
(203) 441-7557
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
10/02/2023
Last updated
01/05/2024
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