Organization
FOUNDATIONS COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRYSTAL L SHOUP DAQUILA LPC (LICENSED PROFESSIONAL COUNSELOR)
(860) 987-7408
Entity
Organization
Contact information
Practice address
2911 DIXWELL AVE STE 105, HAMDEN, CT 06518-3130
(860) 987-7408
Mailing address
44 BARRETT ST, HAMDEN, CT 06517-2503
(860) 987-7408
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
003065
CT
Other
Enumeration date
04/17/2018
Last updated
08/09/2024
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