Provider Demographics
NPI:1003504168
Name:HALCYON PROFESSIONAL COUNSELING
Entity Type:Organization
Organization Name:HALCYON PROFESSIONAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:BRADSHAW
Authorized Official - Last Name:JANKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:617-939-7554
Mailing Address - Street 1:29 TANNERY CT
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-5014
Mailing Address - Country:US
Mailing Address - Phone:617-939-7554
Mailing Address - Fax:
Practice Address - Street 1:74 NEW LONDON TPKE STE 8
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4204
Practice Address - Country:US
Practice Address - Phone:617-939-7554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)