EASTERN SERVICES & CAMP SIMON LLC NPI 1538582739

NPI Information

  • NPI: 1538582739
  • Provider Name: EASTERN SERVICES & CAMP SIMON LLC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 82 MAIN ST
    WINDSOR LOCKS, CT
    ZIP 06096
  • Phone: (860) 254-5127

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NPI Details

EASTERN SERVICES & CAMP SIMON LLC is a professional counselor in Windsor Locks, CT. EASTERN SERVICES & CAMP SIMON LLC NPI is 1538582739. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

82 MAIN ST
WINDSOR LOCKS, CT
ZIP 06096-325
Phone: (860) 254-5127
Fax: (860) 310-4235

The provider's authorized official is Maly Phimvongsa .
The authorized official title is Clinical Director/owner and has the following contact phone number (860) 254-5127.

The enumeration date for this NPI number is 1/24/2014 and was last updated on 2/11/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2101YP2500XCounselorProfessional002227CONNECTICUTNo
3101YP2500XCounselorProfessional001470CONNECTICUTYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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