| Grateful Guidance, Llc | |
|
752 Middletown Rd Colchester CT 06415-2307 | |
| (860) 334-2088 | |
| Not Available |
| Full Name | Grateful Guidance, Llc |
|---|---|
| Speciality | Counselor |
| Location | 752 Middletown Rd, Colchester, Connecticut |
| Authorized Official Name and Position | Andrea Hyatt Shaker (OWNER) |
| Authorized Official Contact | 8603342088 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grateful Guidance, Llc 752 Middletown Rd Colchester CT 06415-2307 Ph: (860) 334-2088 | Grateful Guidance, Llc 752 Middletown Rd Colchester CT 06415-2307 Ph: (860) 334-2088 |
| NPI Number | 1861256141 |
|---|---|
| Provider Enumeration Date | 02/07/2024 |
| Last Update Date | 02/07/2024 |
| Certification Date | 02/07/2024 |
| Medicare PECOS PAC ID | 0446698948 |
|---|---|
| Medicare Enrollment ID | O20240403001254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861256141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Andrea Shaker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134685514 PECOS PAC ID: 4880032382 Enrollment ID: I20240403001378 |
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