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Organization

COLLEGE STREET COUNSELING CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PHILLIP SYLVESTER PH.D. (PARTNER)
(860) 347-8894
Entity
Organization

Contact information

Practice address
154 COLLEGE ST, MIDDLETOWN, CT 06457-3201
(860) 347-8894
(860) 346-2405
Mailing address
154 COLLEGE ST, MIDDLETOWN, CT 06457-3201
(860) 347-8894
(860) 346-2405

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000329
CT
103TC1900X
Counseling Psychologist
1041C0700X
Clinical Social Worker
Primary
004228
CT

Other

Enumeration date
02/23/2012
Last updated
02/23/2012
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