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General NPI Number Information
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NPI Number | 1144902099
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Entity Type | Organization
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Legal Business Name | UNLIMITED ENLIGHTENMENT, LLC
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Dates
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Enumeration Date | 08/01/2023
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 151 MAIN ST STE 2A
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City | SEYMOUR
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State | CT
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Zip | 06483-3137
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Country | US
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Telephone | 475-522-1005
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Fax |
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Provider Business Mailing Address
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Address Line | 102 PEARL ST
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City | SEYMOUR
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State | CT
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Zip | 06483-3708
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | ASHLEY ZAVALKO
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Credential |
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Telephone | 475-243-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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