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General NPI Number Information
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NPI Number | 1689476160
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Entity Type | Organization
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Legal Business Name | CIRCLE OF CONNECTIONS, LLC
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 2111 S RIDGEWOOD AVE UNIT 11
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City | EDGEWATER
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State | FL
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Zip | 32141-4246
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Country | US
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Telephone | 314-913-6646
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 S RIDGEWOOD AVE UNIT 11
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City | EDGEWATER
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State | FL
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Zip | 32141-4246
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Country | US
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Telephone | 386-409-1332
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Fax |
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Authorized Official
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Title or Position | LMHC/OWNER
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Name | KATY REDEL
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Credential | LMHC
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Telephone | 314-913-6646
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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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