Organization
SHORELINE WELLNESS CENTER, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARA M POWERS LPC (COUNSELOR/OWNER)
(203) 931-1184
Entity
Organization
Contact information
Practice address
415 MAIN ST, WEST HAVEN, CT 06516-4296
(203) 931-1194
(203) 931-1184
Mailing address
415 MAIN ST, WEST HAVEN, CT 06516-4296
(203) 931-1194
(203) 931-1184
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
003348
CT
2084P0800X
Psychiatry Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/04/2010
Last updated
11/28/2012
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