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Holly Heaven
Professional Counselor in Bridgeport, Connecticut
NPI 1639791106

Holly Heaven is a Professional Counselor based in Derby, CT and is specialized in Professional. Holly Heaven practices in Bridgeport, CT. The NPI Number for Holly Heaven is 1639791106 and holds a License No. (Connecticut).

The current practice location address for Holly Heaven is 1057 Broad St Ste 304, Bridgeport, CT and can be reached out via phone at 203-545-1582.

Location: 1057 Broad St Ste 304, Bridgeport, CT, 06418-0011
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1639791106
Provider Name
Holly Heaven
Credential
Provider Entity Type
Organization
Address
1057 Broad St Ste 304, Bridgeport, CT, 06418-0011
Phone Number
203-545-1582
Fax Number
Provider Enumeration Date
05/07/2020
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1057 Broad St Ste 304
City
Bridgeport
State
Connecticut
Zip
06604-4219
Phone Number
203-545-1582
Fax Number
person
Provider Business Mailing Address Details
Address
1057 Broad St Ste 304
City
Bridgeport
State
Connecticut
Zip
06604-4219
Phone Number
203-545-1582
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
()
Definition
Definition to come...
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