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General NPI Number Information
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NPI Number | 1447834973
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Entity Type | Organization
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Legal Business Name | STRONG MINDS, LLC
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 05/11/2021
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Provider Practice Location Address
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Address Line | 363 MAIN ST STE 511
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3359
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Country | US
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Telephone | 860-301-3981
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Fax |
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Provider Business Mailing Address
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Address Line | 159 CARRIAGE CROSSING LN
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City | MIDDLETOWN
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State | CT
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Zip | 06457-5833
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Country | US
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Telephone | 860-301-3981
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MISS KATELYNN MARIE BENTO
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Credential | LPC
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Telephone | 860-301-3981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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