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General NPI Number Information
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NPI Number | 1457817678
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Entity Type | Individual
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Provider Name | NICOLE ELIZABETH MCHUGH
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Gender | Female
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 02/12/2019
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Provider Practice Location Address
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Address Line | 360 MAIN ST STE 2D
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3375
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Country | US
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Telephone | 860-539-3282
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Fax |
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Provider Business Mailing Address
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Address Line | 17 BOTELLE MNR
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City | CROMWELL
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State | CT
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Zip | 06416-1301
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Country | US
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Telephone | 860-539-3282
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 003182
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License Number State | CT
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