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Organization

MINDFUL WELLNESS COUNSELING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MONICA SMITH LPC (LICENSED THERAPIST)
(860) 559-0349
Entity
Organization

Contact information

Practice address
915 SULLIVAN AVE STE 4A, SOUTH WINDSOR, CT 06074-2165
(860) 264-5675
Mailing address
22 WAPPING RD, BROAD BROOK, CT 06016-9723
(860) 559-0349

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
251S00000X
Community/Behavioral Health Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1578958013
INDIVIDUAL NPI
CT
Enumeration date
03/24/2020
Last updated
08/04/2023
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