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General NPI Number Information
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NPI Number | 1255934576
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Entity Type | Organization
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Legal Business Name | INSTILLING HOPE COUNSELING LLC
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 45 RUSSELL ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1312
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Country | US
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Telephone | 860-880-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 131 ASHLEY RD
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City | BRISTOL
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State | CT
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Zip | 06010-2606
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Country | US
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Telephone | 860-719-9056
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA ANNETTE ANTUNES
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Credential | MA, LPC
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Telephone | 860-880-0693
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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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