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Organization
SOUTHEAST COUNSELING ASSOCIATES, LTD
Active
Organization
SOUTHEAST COUNSELING ASSOCIATES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HERBERT NIEBURG PH.D. (PRESIDENT)
(860) 599-2125
Entity
Organization
Contact information
Practice address
185 S BROAD ST, SUITE 103, PAWCATUCK, CT 06379-1997
(401) 465-2914
(401) 322-0883
Mailing address
185 S BROAD ST, SUITE 103, PAWCATUCK, CT 06379-1997
(401) 465-2914
(401) 322-0883
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
008200
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008043513
—
CT
Enumeration date
02/11/2015
Last updated
02/11/2015
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