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General NPI Number Information
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NPI Number | 1194128603
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Entity Type | Organization
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Legal Business Name | AG COUNSELING LLC
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Dates
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Enumeration Date | 09/29/2014
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 769 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06032-2310
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Country | US
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Telephone | 860-805-8428
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Fax |
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Provider Business Mailing Address
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Address Line | 158 ODONNELL RD
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City | NEW BRITAIN
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State | CT
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Zip | 06053-1479
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Country | US
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Telephone | 860-805-8428
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ANETA J GALEK
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Credential | LPC, NCC, LADC
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Telephone | 860-805-8428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 001022
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 002538
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License Number State | CT
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