Organization
EVERGROW COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JALEESA M HERNANDEZ LPC, NCC (BEHAVIORAL HEALTH CLINICIAN)
(203) 927-6409
Entity
Organization
Contact information
Practice address
843 MAIN ST STE 2, MANCHESTER, CT 06040-6041
(203) 927-6409
Mailing address
843 MAIN ST STE 2, MANCHESTER, CT 06040-6041
(203) 927-6409
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891038956
—
CT
Enumeration date
10/08/2018
Last updated
09/30/2019
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