Provider Demographics
NPI:1003467580
Name:A.S.C. CLINICAL, COACHING & CONNECTIONS SERVICES, LLC
Entity Type:Organization
Organization Name:A.S.C. CLINICAL, COACHING & CONNECTIONS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:N
Authorized Official - Last Name:SMOKE-COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-433-2256
Mailing Address - Street 1:14 KELLY RD
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-2022
Mailing Address - Country:US
Mailing Address - Phone:203-433-2256
Mailing Address - Fax:
Practice Address - Street 1:14 KELLY RD
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-2022
Practice Address - Country:US
Practice Address - Phone:203-433-2256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1083932735OtherNPI