Healthcare Provider Details

I. General information

NPI: 1982564696
Provider Name (Legal Business Name): HEALING HEARTS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4749 MAIN ST
BRIDGEPORT CT
06606-1805
US

IV. Provider business mailing address

4749 MAIN ST
BRIDGEPORT CT
06606-1805
US

V. Phone/Fax

Practice location:
  • Phone: 475-332-2176
  • Fax: 203-296-1300
Mailing address:
  • Phone: 475-332-2176
  • Fax: 203-296-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: IBIS GUERRERO
Title or Position: PROGRAM MANAGER
Credential: LCSW, LADC
Phone: 475-332-2176