Provider Demographics
NPI:1124696547
Name:HEALTHYSELF COUNSELING LLC
Entity type:Organization
Organization Name:HEALTHYSELF COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAUNAI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-984-9078
Mailing Address - Street 1:494 BRIDGEPORT AVE
Mailing Address - Street 2:UNIT 101 PMB 310
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484
Mailing Address - Country:US
Mailing Address - Phone:203-450-4558
Mailing Address - Fax:
Practice Address - Street 1:494 BRIDGEPORT AVE
Practice Address - Street 2:UNIT 101 PMB 310
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484
Practice Address - Country:US
Practice Address - Phone:203-450-4558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-13
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty