Healthcare Provider Details

I. General information

NPI: 1912716978
Provider Name (Legal Business Name): COMPASSIONATE CONNECTIONS WELLNESS CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2025
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2389 MAIN ST STE 100
GLASTONBURY CT
06033-4617
US

IV. Provider business mailing address

2389 MAIN ST STE 100
GLASTONBURY CT
06033-4617
US

V. Phone/Fax

Practice location:
  • Phone: 203-442-5160
  • 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
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. JESSICA BEA ATTAS
Title or Position: OWNER
Credential: LCSW
Phone: 703-774-7553