Healthcare Provider Details

I. General information

NPI: 1912053786
Provider Name (Legal Business Name): ADRIANA RESTREPO-POWERS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 BOSTON ST STE 2
GUILFORD CT
06437-2817
US

IV. Provider business mailing address

35 BOSTON ST STE 2
GUILFORD CT
06437-2817
US

V. Phone/Fax

Practice location:
  • Phone: 203-907-5995
  • Fax: 203-453-5684
Mailing address:
  • Phone: 203-907-5995
  • Fax: 203-453-5684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number001536
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: