Healthcare Provider Details

I. General information

NPI: 1497539795
Provider Name (Legal Business Name): CONNECT&CARECOUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 08/21/2023
Certification Date: 08/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S COLORADO AVE
STUART FL
34994-3018
US

IV. Provider business mailing address

5316 AMUSEMENT AVE
FORT PIERCE FL
34947-5314
US

V. Phone/Fax

Practice location:
  • Phone: 561-295-9651
  • Fax:
Mailing address:
  • Phone: 772-418-0781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL ROSE KIRSHNER
Title or Position: COUNSELOR
Credential: LMHC, MED
Phone: 772-418-0781