Organization
CULTIVATING CHANGE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE BRENTON LPC, LADC (CLINICIAN/MANAGER)
(860) 965-2443
Entity
Organization
Contact information
Practice address
392 MERROW RD STE B, TOLLAND, CT 06084-3974
(860) 965-2443
Mailing address
4 GLORIA LN, ELLINGTON, CT 06029-2609
(860) 965-2443
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
000964
CT
101YP2500X
Professional Counselor
002338
CT
1041C0700X
Clinical Social Worker
6217
CT
106H00000X
Marriage & Family Therapist
001475
CT
Other
Enumeration date
03/09/2014
Last updated
04/02/2015
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