Organization
COLLABORATIVE CHANGE COUNSELING AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER A Y JOHNSTON M.A. (SOLE PROPRIETOR)
(617) 699-3101
Entity
Organization
Contact information
Practice address
375 MATHER ST, HAMDEN, CT 06514-3101
(203) 745-0733
Mailing address
375 MATHER ST, HAMDEN, CT 06514-3101
(203) 745-0733
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7570
MA
101YP2500X
Professional Counselor
Primary
2205
CT
Other
Enumeration date
03/17/2017
Last updated
03/08/2019
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