Organization
COUNSELING CONNECTION TRAINING INSTITUTE, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEORA ELIZABETH BLACK PH.D. (CLINICAL DIRECTOR)
(802) 264-5333
Entity
Organization
Contact information
Practice address
245 S PARK DR, SUITE 2, COLCHESTER, VT 05446-5972
(802) 264-5333
(802) 264-5338
Mailing address
245 S PARK DR, SUITE 2, COLCHESTER, VT 05446-5972
(802) 264-5333
(802) 264-5338
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011097
—
VT
Enumeration date
12/19/2006
Last updated
08/22/2020
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