Provider Demographics
NPI:1619622388
Name:GREENHARMONY COUNSELING, LCC
Entity Type:Organization
Organization Name:GREENHARMONY COUNSELING, LCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORK/ THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:IVELISSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-631-8271
Mailing Address - Street 1:473 ALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-3607
Mailing Address - Country:US
Mailing Address - Phone:203-631-8271
Mailing Address - Fax:
Practice Address - Street 1:710 MAIN STREET
Practice Address - Street 2:BLDG 2; 2ND FL
Practice Address - City:PLANTSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06479
Practice Address - Country:US
Practice Address - Phone:203-631-8271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty