Healthcare Provider Details
I. General information
NPI: 1295193464
Provider Name (Legal Business Name): COURTNEY HUANG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/03/2016
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
114 E MAIN ST
CLINTON CT
06413-2131
US
IV. Provider business mailing address
114 E MAIN ST
CLINTON CT
06413-2131
US
V. Phone/Fax
- Phone: 860-347-6971
- Fax:
- Phone: 860-347-6971
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 003299 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: