Healthcare Provider Details

I. General information

NPI: 1164331088
Provider Name (Legal Business Name): PERSONAL EXPORATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 S MAIN ST
COLCHESTER CT
06415-1405
US

IV. Provider business mailing address

244 S MAIN ST
COLCHESTER CT
06415-1405
US

V. Phone/Fax

Practice location:
  • Phone: 860-377-7000
  • Fax: 860-537-5426
Mailing address:
  • Phone: 860-377-7000
  • Fax: 860-537-5426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANDREA CYR
Title or Position: OWNER
Credential: LPC
Phone: 860-377-7000