Provider Demographics
NPI:1164909917
Name:BROWNBEAR AND OWL HOLISTIC COUNSELING, LLC
Entity Type:Organization
Organization Name:BROWNBEAR AND OWL HOLISTIC COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE/MEMBER MANAGED
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:MARONE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, ATR
Authorized Official - Phone:860-302-5603
Mailing Address - Street 1:1 ABBOTT RD UNIT 8
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-3863
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56 ARBOR ST STE 216
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1224
Practice Address - Country:US
Practice Address - Phone:860-302-5603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health