Petalu'Da Autism Services LLC
Counselor, Professional in Vernon, Connecticut
1245578475- Practice location
- 6 Elizabeth Ln, Vernon, CT 06066-5056
- Phone
- 860-983-8112
- Fax
- —
- Last updated
- November 8, 2014
Petalu'Da Autism Services LLC is a healthcare organization based in Vernon, CT. Petalu'Da Autism Services LLC practices in Vernon, CT. The NPI Number for Petalu'Da Autism Services LLC is 1245578475 and holds a License No. 3928518916 (CT). The current practice location address for Petalu'Da Autism Services LLC is 6 Elizabeth Ln, Vernon, CT 06066-5056 and can be reached out via phone at 860-983-8112.
Provider Profile Details
- NPI Number
- 1245578475
- Provider Name
- Petalu'Da Autism Services LLC
- Provider Entity Type
- Organization
- Address
- 6 Elizabeth Ln, Vernon, CT 06066-5056
- Phone Number
- 860-983-8112
- Primary Taxonomy
- Counselor, Professional · 101YP2500X
- Organization Subpart
- No
- Authorized Official
- Miss Keisha Powell, SPED/CASD · Autism Therapist · 860-983-8112
- Provider Enumeration Date
- January 23, 2013
- Last Update Date
- November 8, 2014
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 6 Elizabeth Ln
Vernon, CT 06066-5056 - City
- Vernon
- State
- Connecticut
- Zip
- 06066-5056
- Phone Number
- 860-983-8112
Provider Business Mailing Address Details
- Address
- 6 Elizabeth Ln
Vernon, CT 06066-5056 - City
- Vernon
- State
- CT
- Zip
- 06066-5056
- Phone Number
- 860-983-8112
License Information
- License Number (1)
- 3928518916
- License State (1)
- CT
- Taxonomy (1)
- Point of Service · 305S00000X
- License Number (2)
- 11211741
- License State (2)
- CT
- Taxonomy (2)
- Counselor, Professional · 101YP2500X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Counselor, Professional providers near Vernon, CT
View all Counselor, Professional providers in Vernon →- Dalton R Hall, LPCACounselor, Professional · NPI 1528700804
- Deep Breaths Counseling LLCCounselor, Professional · NPI 1720571029
- Dr. Sursatie D Chetram, PHD, LPCCounselor, Professional · NPI 1235639444
- Erica Y Bower, MS ED LPCCounselor, Professional · NPI 1902147622
- Jennifer J BanningCounselor, Professional · NPI 1326401910
- Miss Melanie L Winkler, LPCCounselor, Professional · NPI 1235315870
Frequently Asked Questions
What is the NPI number of Petalu'Da Autism Services LLC?
The NPI number of Petalu'Da Autism Services LLC is 1245578475. It was assigned on January 23, 2013 and is currently active in the NPPES registry.
What is the specialty of Petalu'Da Autism Services LLC?
Petalu'Da Autism Services LLC is registered under the primary taxonomy Counselor, Professional (code 101YP2500X), licensed in CT under license number 3928518916.
Where does Petalu'Da Autism Services LLC practice?
The practice location is 6 Elizabeth Ln, Vernon, CT 06066-5056. The office can be reached at 860-983-8112 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1245578475 directly on the NPPES registry website.