Provider Demographics
NPI:1679373161
Name:FAIR WINDS COUNSELING, LLC
Entity type:Organization
Organization Name:FAIR WINDS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SCAVETTA RAMSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-625-5250
Mailing Address - Street 1:12 ROOSEVELT AVE STE 30
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-2809
Mailing Address - Country:US
Mailing Address - Phone:860-625-5250
Mailing Address - Fax:
Practice Address - Street 1:12 ROOSEVELT AVE STE 30
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2809
Practice Address - Country:US
Practice Address - Phone:860-625-5250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health