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General NPI Number Information
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NPI Number | 1164909917
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Entity Type | Organization
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Legal Business Name | BROWNBEAR AND OWL HOLISTIC COUNSELING, LLC
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 56 ARBOR ST STE 216
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City | HARTFORD
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State | CT
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Zip | 06106-1224
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Country | US
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Telephone | 860-302-5603
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Fax |
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Provider Business Mailing Address
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Address Line | 1 ABBOTT RD UNIT 8
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City | ELLINGTON
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State | CT
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Zip | 06029-3863
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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 | PRINCIPLE/MEMBER MANAGED
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Name | SHANNON MARONE
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Credential | LPC, ATR
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Telephone | 860-302-5603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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