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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARLA S RICCI LMFT (LMFT)
(860) 416-3814
Entity
Organization

Contact information

Practice address
44 LEBANON RD, BOZRAH, CT 06334-1116
(860) 416-3814
Mailing address
44 LEBANON RD, BOZRAH, CT 06334-1116
(860) 416-3814

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CT
101YM0800X
Mental Health Counselor
CT
104100000X
Social Worker
CT
1041C0700X
Clinical Social Worker
CT
106H00000X
Marriage & Family Therapist
Primary
001495
CT

Other

Enumeration date
09/27/2013
Last updated
11/10/2014
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