Healthcare Provider Details

I. General information

NPI: 1326620097
Provider Name (Legal Business Name): PEPPERTREE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 DEPOT PL STE 4
BETHEL CT
06801-2540
US

IV. Provider business mailing address

9 LIMEKILN CT
BETHEL CT
06801-3234
US

V. Phone/Fax

Practice location:
  • Phone: 203-292-0856
  • Fax:
Mailing address:
  • Phone: 203-292-0856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. DANIELLE MONROE
Title or Position: PROVIDER/MENTAL HEALTH COUNSELOR
Credential: LPC
Phone: 203-292-0856