Holly Heaven
Counselor, Mental Health in Bridgeport, CT. Organization (NPI-2).
NPI number1639791106
StatusActive
Last updated in NPPESJan 19, 2021
Details
- NPI
- 1639791106
- Entity type
- Organization (NPI-2)
- Legal business name
- Holly Heaven
- Organization subpart
- No
- Enumeration date
- May 7, 2020
- Certification date
- Jan 19, 2021
- Last updated
- Jan 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 101Y00000X | Counselor | – | – | |
| 101YP2500X | Counselor, Professional | – | – |
Other names
- Another Way Counseling Service LLC (Doing Business As)
Practice location
1057 Broad St Ste 304Bridgeport, CT 06604-4219
Phone 203-545-1582
Mailing address
Po Box 11Derby, CT 06418-0011
Phone 203-545-1582
Authorized official
Holly Heaven
Owner
2035451582
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