Healthcare Provider Details

I. General information

NPI: 1649182379
Provider Name (Legal Business Name): FAITH, HOPE, AND LOVE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 LEWIS RD
BRISTOL CT
06010-3635
US

IV. Provider business mailing address

33 LEWIS RD
BRISTOL CT
06010-3635
US

V. Phone/Fax

Practice location:
  • Phone: 203-592-5140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. GENESIS OTERO
Title or Position: OWNER
Credential: LCSW
Phone: 203-592-5140