Healthcare Provider Details

I. General information

NPI: 1750037545
Provider Name (Legal Business Name): CONNECTING THE DOTS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 03/03/2022
Certification Date: 03/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5124 SE HARBOR TER
STUART FL
34997-2572
US

IV. Provider business mailing address

5124 SE HARBOR TER
STUART FL
34997-2572
US

V. Phone/Fax

Practice location:
  • Phone: 772-218-0642
  • Fax:
Mailing address:
  • Phone: 772-218-0642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. LESLIE SOULEK
Title or Position: CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 772-218-0642