Organization
HOLLY HEAVEN
Active
Other names
Another Way Counseling Service LLC
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY HEAVEN LPC (OWNER)
(203) 545-1582
Entity
Organization
Contact information
Practice address
1057 BROAD ST STE 304, BRIDGEPORT, CT 06604-4219
(203) 545-1582
Mailing address
PO BOX 11, DERBY, CT 06418-0011
(203) 545-1582
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
05/07/2020
Last updated
01/19/2021
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