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General NPI Number Information
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NPI Number | 1811596737
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Entity Type | Organization
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Legal Business Name | COUNSELING CONNECTIONS LLC
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 1301 REDWOOD WAY STE 223
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City | PETALUMA
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State | CA
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Zip | 94954-1136
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Country | US
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Telephone | 415-840-8622
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Fax |
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Provider Business Mailing Address
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Address Line | 1831 CARNEROS CIR
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City | PETALUMA
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State | CA
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Zip | 94954-7471
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Country | US
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Telephone | 415-840-6822
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSEL
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Name | ERICA SCHABATKA
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Credential | MA
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Telephone | 415-840-6822
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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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