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NPI Code Detail

MEDICARE: HOLISTIC COUNSELING OF GREATER DANBURY LLC

MEDICARE: HOLISTIC COUNSELING OF GREATER DANBURY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor001235CT

General Provider Information

NPI Number : 1427557602
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOLISTIC COUNSELING OF GREATER DANBURY LLC
Provider Business Mailing Address
First Line : 15 NORTH ST
Second Line :
City : DANBURY
State : CT
Zip : 06810-5604
Country : US
Telephone Number : 203-885-2305
Fax Number :
Provider Business Practice Location Address
First Line : 15 NORTH ST
Second Line :
City : DANBURY
State : CT
Zip : 06810-5604
Country : US
Telephone Number : 203-885-2305
Fax Number :
Authorized Official
Title or Position : COUNSELOR/SOLE PROPRIETOR
Name : HOLLY LAKIA COLON
Credential : LADC, LPC
Telephone Number : 203-885-2305
Provider Enumeration Date : 02/02/2018
Last Update Date : 09/28/2018

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