Healthcare Provider Details

I. General information

NPI: 1487424792
Provider Name (Legal Business Name): B & B COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 BURR ST
NEW HAVEN CT
06512-3908
US

IV. Provider business mailing address

37 BURR ST
NEW HAVEN CT
06512-3908
US

V. Phone/Fax

Practice location:
  • Phone: 475-434-6050
  • Fax:
Mailing address:
  • Phone: 475-434-6050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIAN ADAM BONILLA
Title or Position: OWNER
Credential: LPC, LADC
Phone: 475-434-6050