| Anchored Soul Counseling, Pllc | |
|
262 State St Ste C North Haven CT 06473-2273 | |
| (203) 980-7454 | |
| Not Available |
| Full Name | Anchored Soul Counseling, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 262 State St Ste C, North Haven, Connecticut |
| Authorized Official Name and Position | Shane Mahon (OWNER) |
| Authorized Official Contact | 2039807454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anchored Soul Counseling, Pllc 262 State St Ste C North Haven CT 06473-2273 Ph: (203) 980-7454 | Anchored Soul Counseling, Pllc 262 State St Ste C North Haven CT 06473-2273 Ph: (203) 980-7454 |
| NPI Number | 1619515962 |
|---|---|
| Provider Enumeration Date | 12/17/2019 |
| Last Update Date | 05/03/2021 |
| Certification Date | 05/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619515962 | NPI | - | NPPES |
| 1457949117 | Medicaid | CT | |
| 1841774254 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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