Healthcare Provider Details
I. General information
NPI: 1386847200
Provider Name (Legal Business Name): AVA KORDANSKY MA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
45 SO MAIN ST SUITE 208
WEST HARTFORD CT
06107
US
IV. Provider business mailing address
12 QUAIL HOLLOW
WEST HARTFORD CT
06107
US
V. Phone/Fax
- Phone: 860-232-9228
- Fax: 860-236-5110
- Phone: 860-232-9228
- Fax: 860-236-5110
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 59186 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 000375 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: