Organization
CONNECT & GROW COUNSELING LLC
Active
Other names
Connect & Grow Counseling LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVA SAN PEDRO-KOONTZ M.S. (FOUNDER & PSYCHOTHERAPIST)
(773) 971-1266
Entity
Organization
Contact information
Practice address
1350 BALD EAGLE DRIVE, NAPLES, FL 34105-7415
(773) 971-1266
Mailing address
1350 BALD EAGLE DRIVE, NAPLES, FL 34105-7415
(773) 971-1266
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12583405
CAQH/PROVIEW NUMBER
IL
01
—
180012733
LICENSED CLINICAL PROFESSIONAL COUNSELOR LICENSE NUMBER
IL
01
—
1982045175
INDIVIDUAL NPI NUMBER/TYPE 1 NPI
IL
Enumeration date
01/22/2025
Last updated
01/22/2025
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