Healthcare Provider Details

I. General information

NPI: 1831796234
Provider Name (Legal Business Name): SHARING ABILITIES COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 BROAD STREET SUITE 100
WINDSOR CT
06095
US

IV. Provider business mailing address

146 HAROLD STREET
HARTFORD CT
06112
US

V. Phone/Fax

Practice location:
  • Phone: 860-602-8849
  • Fax:
Mailing address:
  • Phone: 860-602-8849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. JACQUELINE PATRICIA MCDERMOTT-SELMAN
Title or Position: CEO-LEAD CLINICIAN
Credential: LADC
Phone: 860-983-7388