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General NPI Number Information
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NPI Number | 1659914331
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Entity Type | Organization
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Legal Business Name | HEART CENTERED COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 674 PROSPECT AVE STE 206
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City | HARTFORD
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State | CT
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Zip | 06105-4288
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Country | US
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Telephone | 860-920-2193
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Fax | 860-578-9122
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Provider Business Mailing Address
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Address Line | 25 CHRISTMAS TREE HL
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City | CANTON
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State | CT
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Zip | 06019-2127
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Country | US
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Telephone | 860-920-2193
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | DR. RAMON VEGA DE JESUS
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Credential | PH.D.
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Telephone | 860-920-2193
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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 |
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License Number State |
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