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General NPI Number Information
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NPI Number | 1972990059
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Entity Type | Organization
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Legal Business Name | HEALTHWISE COUNSELING, LLC
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 50 ALBANY TPKE SUITE 3010
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City | CANTON
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State | CT
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Zip | 06019-2516
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Country | US
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Telephone | 860-479-2563
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Fax |
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Provider Business Mailing Address
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Address Line | 50 ALBANY TPKE SUITE 3010
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City | CANTON
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State | CT
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Zip | 06019-2516
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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 | MEMBER
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Name | KRISTINA SCHUMANN
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Credential | PH.D.
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Telephone | 860-479-2563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 003434
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License Number State | CT
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