Healthcare Provider Details

I. General information

NPI: 1609685478
Provider Name (Legal Business Name): GOOD MORNING GODDESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 FARMINGTON AVE APT A2
WEST HARTFORD CT
06119-1737
US

IV. Provider business mailing address

711 FARMINGTON AVE APT A2
WEST HARTFORD CT
06119-1737
US

V. Phone/Fax

Practice location:
  • Phone: 860-404-6066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: CHANTELLE JOHNSON
Title or Position: OWNER/OPERATOR
Credential: HBC-HWC, SFC, CPT
Phone: 860-478-2376