Healthcare Provider Details

I. General information

NPI: 1346108214
Provider Name (Legal Business Name): CONSCIOUS CONNECTIONS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 S CHAPEL ST
NEWARK DE
19713-3467
US

IV. Provider business mailing address

910 S CHAPEL ST STE 104
NEWARK DE
19713-3468
US

V. Phone/Fax

Practice location:
  • Phone: 302-602-2364
  • Fax:
Mailing address:
  • Phone: 302-602-2364
  • Fax: 800-619-4736

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: SHAWN TABOR
Title or Position: OWNER
Credential: LPC, NCC
Phone: 302-602-2364