Organization
COUNSELING CONNECTION TRAINING INSTITUTE, PLC
Active
Other names
Counseling Conection Training Institute, PLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEORA ELIZABETH BLACK PH.D. (CLINICAL DIRECTOR)
(802) 264-5333
Entity
Organization
Contact information
Practice address
525 HERCULES DR, SUITE 1A, COLCHESTER, VT 05446-5993
(802) 264-5333
(802) 264-5338
Mailing address
525 HERCULES DR, SUITE 1A, COLCHESTER, VT 05446-5993
(802) 264-5333
(802) 264-5338
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000067
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011097
—
VT
Enumeration date
03/14/2007
Last updated
07/13/2016
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