Provider Demographics
NPI:1184962250
Name:ORACLE COUNSELING & WELLNESS
Entity type:Organization
Organization Name:ORACLE COUNSELING & WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LICENSED CLINICAL SOCIAL WOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JACARUSO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:203-859-1026
Mailing Address - Street 1:99 CHERRY ST STE D
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3455
Mailing Address - Country:US
Mailing Address - Phone:203-859-1026
Mailing Address - Fax:203-283-7857
Practice Address - Street 1:99 CHERRY ST STE D
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3455
Practice Address - Country:US
Practice Address - Phone:203-859-1026
Practice Address - Fax:203-283-7857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0059291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1851319412Medicaid