Provider Demographics
NPI:1417554866
Name:HEART AND CROWN HEALING, LLC
Entity Type:Organization
Organization Name:HEART AND CROWN HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ALYSIA
Authorized Official - Middle Name:CHERIE
Authorized Official - Last Name:SKLENARIK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-709-1866
Mailing Address - Street 1:38 FARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1308
Mailing Address - Country:US
Mailing Address - Phone:203-709-1866
Mailing Address - Fax:
Practice Address - Street 1:609 W JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-4505
Practice Address - Country:US
Practice Address - Phone:203-709-1866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty