Provider Demographics
NPI:1902138100
Name:CONNECTIONS FOR LIFE COUNSELING, LLC
Entity Type:Organization
Organization Name:CONNECTIONS FOR LIFE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-502-9847
Mailing Address - Street 1:7400 BROOK ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23227
Mailing Address - Country:US
Mailing Address - Phone:804-261-2225
Mailing Address - Fax:804-261-2226
Practice Address - Street 1:7400 BROOK ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23227
Practice Address - Country:US
Practice Address - Phone:804-261-2225
Practice Address - Fax:804-261-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004235101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty