Healthcare Provider Details

I. General information

NPI: 1992585293
Provider Name (Legal Business Name): KATERINA VALENTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 FOREST ST
HARTFORD CT
06118-2310
US

IV. Provider business mailing address

1 PARK RD APT 203
WEST HARTFORD CT
06119-3804
US

V. Phone/Fax

Practice location:
  • Phone: 860-249-0975
  • Fax: 833-968-2486
Mailing address:
  • Phone: 860-888-6921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: