Healthcare Provider Details

I. General information

NPI: 1366005100
Provider Name (Legal Business Name): ACTIVATE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 SPIELMAN HWY STE 300
BURLINGTON CT
06013-1723
US

IV. Provider business mailing address

84 S EAGLE ST
TERRYVILLE CT
06786-6104
US

V. Phone/Fax

Practice location:
  • Phone: 860-431-3342
  • Fax:
Mailing address:
  • Phone: 860-431-3342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. SATINA CONFORTI
Title or Position: OWNER
Credential:
Phone: 860-617-2348