Provider Demographics
NPI:1447640131
Name:OVERCOMING LIFE'S OBSTACLES COUNSELING LLC
Entity type:Organization
Organization Name:OVERCOMING LIFE'S OBSTACLES COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NADIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLCE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-805-9919
Mailing Address - Street 1:PO BOX 11592
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06703-0592
Mailing Address - Country:US
Mailing Address - Phone:203-805-9919
Mailing Address - Fax:
Practice Address - Street 1:421 WOLCOTT RD
Practice Address - Street 2:SUITE B
Practice Address - City:WOLCOTT
Practice Address - State:CT
Practice Address - Zip Code:06716-2661
Practice Address - Country:US
Practice Address - Phone:203-805-9919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0085151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1659645323OtherINDIVIDUAL NPI