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General NPI Number Information
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NPI Number | 1558137349
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL SUPPORTIVE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 12/01/2023
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 360 BLOOMFIELD AVE STE 301
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City | WINDSOR
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State | CT
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Zip | 06095-2700
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Country | US
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Telephone | 186-607-3285
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Fax | 860-569-7015
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Provider Business Mailing Address
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Address Line | 368 OCONNELL DR
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City | EAST HARTFORD
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State | CT
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Zip | 06118-3445
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Country | US
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Telephone | 186-324-0808
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Fax | 860-569-7015
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Authorized Official
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Title or Position | OWNER
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Name | NORMA JOY B-MULLINGS
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Credential | LADC
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Telephone | 860-324-0808
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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 |
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License Number State |
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