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Individual

GEORGIA G HYNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCDP,CCS,CAC,NCACII

Contact information

Practice address
8 TITUS RD, BOX 560, WASHINGTON DEPOT, CT 06794-1517
(860) 868-0857
(860) 868-1288
Mailing address
8 TITUS RD, P.O. BOX 560, WASHINGTON DEPOT, CT 06794-1517
(860) 868-0857
(860) 868-1288

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000322
CT
101YM0800X
Mental Health Counselor
000322
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000322
STATE OF CT DEPARTMENT OF PUBLIC HEALTH
CT
01
CAC-1410
CONNECTICUT CERTIFICATION BOARD
CT
01
CAC-4490
NEW YORK STATE OASAS
NY
01
CCDP-1410
CONNECTICUT CERTIFICATION BOARD
CT
01
CCS-1410
CONNECTICUT CERTIFICATION BOARD
CT
01
NCACII -004029
NAADAC
VA
Enumeration date
02/07/2007
Last updated
04/01/2009
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