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NPI Code Detail

MEDICARE: LIVE BY THE SUN FEEL BY THE MOON

MEDICARE: LIVE BY THE SUN FEEL BY THE MOON
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
1101Y00000XCounselor003036CT

General Provider Information

NPI Number : 1336680156
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIVE BY THE SUN FEEL BY THE MOON
Provider Business Mailing Address
First Line : 128 GARDEN ST
Second Line :
City : FARMINGTON
State : CT
Zip : 06032-2254
Country : US
Telephone Number : 860-716-5318
Fax Number : 860-231-8006
Provider Business Practice Location Address
First Line : 128 GARDEN ST
Second Line :
City : FARMINGTON
State : CT
Zip : 06032-2254
Country : US
Telephone Number : 860-716-5318
Fax Number : 860-231-8006
Authorized Official
Title or Position : LICENSED PROFESSIONAL COUNSELOR
Name : GINA GOLDSTEIN
Credential : M.S., LPC
Telephone Number : 860-716-5318
Provider Enumeration Date : 03/13/2017
Last Update Date : 03/13/2017

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Directions to “LIVE BY THE SUN FEEL BY THE MOON ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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