| Evergrow Counseling Llc | |
|
843 Main St Ste 2 Manchester CT 06040-6041 | |
| (203) 927-6409 | |
| Not Available |
| Full Name | Evergrow Counseling Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 843 Main St Ste 2, Manchester, Connecticut |
| Authorized Official Name and Position | Jaleesa M Hernandez (BEHAVIORAL HEALTH CLINICIAN) |
| Authorized Official Contact | 2039276409 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergrow Counseling Llc 843 Main St Ste 2 Manchester CT 06040-6041 Ph: (203) 927-6409 | Evergrow Counseling Llc 843 Main St Ste 2 Manchester CT 06040-6041 Ph: (203) 927-6409 |
| NPI Number | 1487129284 |
|---|---|
| Provider Enumeration Date | 10/08/2018 |
| Last Update Date | 09/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487129284 | NPI | - | NPPES |
| 1891038956 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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