Provider Demographics
NPI:1497539795
Name:CONNECT&CARECOUNSELING LLC
Entity Type:Organization
Organization Name:CONNECT&CARECOUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:KIRSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, MED
Authorized Official - Phone:772-418-0781
Mailing Address - Street 1:5316 AMUSEMENT AVE
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-5314
Mailing Address - Country:US
Mailing Address - Phone:772-418-0781
Mailing Address - Fax:
Practice Address - Street 1:700 S COLORADO AVE
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3018
Practice Address - Country:US
Practice Address - Phone:561-295-9651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health