=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821493313
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INNER STRENGTH COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2014
-----------------------------------------------------
Last Update Date | 07/26/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 PROGRESS DR STE 2G
-----------------------------------------------------
City | SHELTON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06484-6294
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 475-777-5905
-----------------------------------------------------
Fax | 475-777-5909
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20 COLONY ST
-----------------------------------------------------
City | DERBY
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06418-1230
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-962-6589
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. MELISSA CAREY PERKINS
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 860-324-0653
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 001667
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 002569
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------