Organization
CLOUD-SHINE COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCHERELL D.G. BRYAN (OWNER)
(225) 715-0608
Entity
Organization
Contact information
Practice address
67 RUSS ST, HARTFORD, CT 06106-5408
(225) 715-0608
Mailing address
67 RUSS ST, HARTFORD, CT 06106-5408
(225) 715-0608
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XXXXXX
XXXXX
—
Enumeration date
08/25/2022
Last updated
10/27/2022
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