Provider Demographics
NPI:1013364942
Name:THE ENLIGHTENMENT COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:THE ENLIGHTENMENT COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALZATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-729-6138
Mailing Address - Street 1:998 FARMINGTON AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2162
Mailing Address - Country:US
Mailing Address - Phone:860-729-6138
Mailing Address - Fax:860-519-5723
Practice Address - Street 1:660 PROSPECT AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-4230
Practice Address - Country:US
Practice Address - Phone:860-729-6138
Practice Address - Fax:860-519-5723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 106H00000X
CT76731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty