MEDICARE: PROGRESSIONS,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	002794	CT

General Provider Information

NPI Number	:	1285146910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROGRESSIONS,LLC

Provider Business Mailing Address
First Line	:	934 QUEEN ST FL 2
Second Line	:
City	:	SOUTHINGTON
State	:	CT
Zip	:	06489-2161
Country	:	US
Telephone Number	:	860-479-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	934 QUEEN ST FL 2
Second Line	:
City	:	SOUTHINGTON
State	:	CT
Zip	:	06489-2161
Country	:	US
Telephone Number	:	860-479-2511
Fax Number	:

Authorized Official
Title or Position	:	PROFESSIONAL COUNSELOR
Name	:	MRS. LISA HAYES
Credential	:	LPC
Telephone Number	:	806-479-2511

Provider Enumeration Date	:	11/03/2017
Last Update Date	:	07/12/2019

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