Provider Demographics
NPI:1235981754
Name:HUMAN CONNECTION COUNSELING COLLECTIVE, LLC
Entity Type:Organization
Organization Name:HUMAN CONNECTION COUNSELING COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:GENEVIEVE
Authorized Official - Last Name:AMARAL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:562-234-8411
Mailing Address - Street 1:1612 ALVARADO DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6508
Mailing Address - Country:US
Mailing Address - Phone:562-234-8411
Mailing Address - Fax:
Practice Address - Street 1:2 SYLVAN RD
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-4333
Practice Address - Country:US
Practice Address - Phone:562-234-8411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty