Provider Demographics
NPI:1356678551
Name:BREAKTHROUGH COUNSELING LLC
Entity Type:Organization
Organization Name:BREAKTHROUGH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FIKESOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYENI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-918-3663
Mailing Address - Street 1:46 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:CT
Mailing Address - Zip Code:06447-1151
Mailing Address - Country:US
Mailing Address - Phone:860-918-3663
Mailing Address - Fax:
Practice Address - Street 1:1001 FARMINGTON AVE STE 302
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-3990
Practice Address - Country:US
Practice Address - Phone:860-918-3663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT07161251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management