MEDICARE: ATLAS COUNSELING 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1932063245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLAS COUNSELING LLC

Provider Business Mailing Address
First Line	:	200 ELM ST APT 314
Second Line	:
City	:	WEST HAVEN
State	:	CT
Zip	:	06516-4665
Country	:	US
Telephone Number	:	203-212-9169
Fax Number	:	475-306-6786

Provider Business Practice Location Address
First Line	:	200 ELM ST APT 314
Second Line	:
City	:	WEST HAVEN
State	:	CT
Zip	:	06516-4665
Country	:	US
Telephone Number	:	203-212-9169
Fax Number	:	475-306-6786

Authorized Official
Title or Position	:	OWNER
Name	:	ROYCE MANIFOLD
Credential	:
Telephone Number	:	203-212-9169

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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