Organization
CREATE SPACE WELLNESS SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TABIA L THORNTON-BEY LCSW (CEO/ FOUNDER)
(860) 869-2021
Entity
Organization
Contact information
Practice address
330 MAIN ST FL 2, HARTFORD, CT 06106-1851
(860) 869-2021
Mailing address
45 HARTZ LN, EAST HARTFORD, CT 06118-1718
(860) 869-2021
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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