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Contact Information

AUTHENTIC BALANCE CONSORTIUM LLC
267 WILLIMANTIC RD
SUITE 5
CHAPLIN, CT06235-2516
 Phone: 860-617-2848
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for AUTHENTIC BALANCE CONSORTIUM LLC · (Female)

NPI Number 1538347349
Status Active
Credentials
Entity Individual
Enumeration date 02/04/2008
Last updated 02/04/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • CT License # 001484
  • CT License # 006609
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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