Healthcare Provider Details
I. General information
NPI: 1235272725
Provider Name (Legal Business Name): A BETTER LIFE COUNSELING & PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2007
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8 WAKEMAN RD
FAIRFIELD CT
06824-5120
US
IV. Provider business mailing address
500 MONROE TPKE STE B SUITE 171
MONROE CT
06468-2387
US
V. Phone/Fax
- Phone: 203-313-2635
- Fax: 203-268-7760
- Phone: 203-313-2635
- Fax: 203-268-7760
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | 002639 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 002639 |
| License Number State | CT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | 002639 |
| License Number State | CT |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TP2701X |
| Taxonomy | Group Psychotherapy Psychologist |
| License Number | 002639 |
| License Number State | CT |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 002639 |
| License Number State | CT |
VIII. Authorized Official
Name: DR.
JOSIE
VEGA
HINSON
Title or Position: OWNER & CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 203-313-2635