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General NPI Number Information
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NPI Number | 1417516634
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Entity Type | Organization
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Legal Business Name | CONNECTING HEARTS THERAPY, LLC
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 11/20/2019
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Provider Practice Location Address
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Address Line | 542 HOPMEADOW ST STE 305
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City | SIMSBURY
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State | CT
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Zip | 06070-5405
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Country | US
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Telephone | 860-428-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 542 HOPMEADOW ST STE 305
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City | SIMSBURY
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State | CT
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Zip | 06070-5405
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Country | US
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Telephone | 860-428-3400
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE AND FAMILY THERAP
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Name | DESTINY GILLMAN
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Credential | LMFT
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Telephone | 860-428-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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