Provider Demographics
NPI:1730851395
Name:CLINTON HUMAN SERVICES LPC
Entity type:Organization
Organization Name:CLINTON HUMAN SERVICES LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGLINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-664-1155
Mailing Address - Street 1:48 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-2035
Mailing Address - Country:US
Mailing Address - Phone:860-664-1158
Mailing Address - Fax:
Practice Address - Street 1:48 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:CT
Practice Address - Zip Code:06413-2035
Practice Address - Country:US
Practice Address - Phone:860-664-1158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINTON HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-01
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty