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Organization

COLLABORATIVE COUNSELING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORI KUNTZ LMFT (OWNER)
(203) 879-4424
Entity
Organization

Contact information

Practice address
1495 WOLCOTT RD, WOLCOTT, CT 06716-1321
(203) 879-4424
(203) 879-4442
Mailing address
PO BOX 453, BRISTOL, CT 06011-0453
(203) 879-4424
(203) 879-4442

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
002310
CT
1041C0700X
Clinical Social Worker
006562
CT
106H00000X
Marriage & Family Therapist
Primary
001113
CT
106H00000X
Marriage & Family Therapist
001496
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008024276
CT
05
008040740
CT
Enumeration date
04/30/2013
Last updated
04/30/2013
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