| Igniting Hope Counseling Services, Llc | |
|
1740 Ellington Rd South Windsor CT 06074-2768 | |
| (860) 812-4322 | |
| Not Available |
| Full Name | Igniting Hope Counseling Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1740 Ellington Rd, South Windsor, Connecticut |
| Authorized Official Name and Position | Emily D Lewis (OWNER) |
| Authorized Official Contact | 8608124322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Igniting Hope Counseling Services, Llc 117 E Center St Manchester CT 06040-5246 Ph: (860) 812-4322 | Igniting Hope Counseling Services, Llc 1740 Ellington Rd South Windsor CT 06074-2768 Ph: (860) 812-4322 |
| NPI Number | 1437604840 |
|---|---|
| Provider Enumeration Date | 08/16/2016 |
| Last Update Date | 11/24/2020 |
| Certification Date | 11/24/2020 |
| Medicare PECOS PAC ID | 8628358686 |
|---|---|
| Medicare Enrollment ID | O20161208000765 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437604840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 008731 (Connecticut) | Primary |
| Provider Name | Emily D Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316490097 PECOS PAC ID: 8527348580 Enrollment ID: I20161208000930 |
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