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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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