Provider Demographics
NPI:1619284593
Name:INLIGHT PROFESSIONAL COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:INLIGHT PROFESSIONAL COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ARCHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-655-2048
Mailing Address - Street 1:70 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:DANIELSON
Mailing Address - State:CT
Mailing Address - Zip Code:06239-3014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:DANIELSON
Practice Address - State:CT
Practice Address - Zip Code:06239-3014
Practice Address - Country:US
Practice Address - Phone:860-655-2048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001965101YM0800X
CT001069106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty