Organization
SUPPORTIVE COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER B MELQUIST MA, LPC (OWNER)
(860) 305-6164
Entity
Organization
Contact information
Practice address
843 MAIN ST, SUITE 11, MANCHESTER, CT 06040-6020
(860) 305-6164
Mailing address
41 KENSINGTON ST, MANCHESTER, CT 06040-5421
(860) 305-6164
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
001277
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001277
CT LICENSED PROFESSIONAL COUNSELOR
CT
Enumeration date
02/05/2011
Last updated
02/05/2011
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