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General NPI Number Information
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NPI Number | 1346697224
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Entity Type | Organization
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Legal Business Name | HOLISTIC COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 663 WEST AVE APT 24
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City | MILFORD
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State | CT
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Zip | 06461-3062
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Country | US
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Telephone | 203-240-9476
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Fax |
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Provider Business Mailing Address
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Address Line | 663 WEST AVE APT 24
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City | MILFORD
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State | CT
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Zip | 06461-3062
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Country | US
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Telephone | 203-240-9476
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MS. MEGAN TREDENNICK
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Credential | LPC, LADC, ADS
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Telephone | 203-240-9476
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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 | 1105
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2050
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License Number State | CT
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