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General NPI Number Information
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NPI Number | 1700790292
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Entity Type | Organization
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Legal Business Name | PEARL HAVEN COUNSELING FOR MENTAL & BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 4 CARPENTER LN
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City | BLOOMFIELD
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State | CT
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Zip | 06002-1818
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Country | US
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Telephone | 860-922-0649
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CARPENTER LN
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City | BLOOMFIELD
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State | CT
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Zip | 06002-1818
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICIAN & CEO
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Name | PHILLIPIA POTTINGER
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Credential | LCSW
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Telephone | 860-922-0649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | NULL
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