Provider Demographics
NPI:1780290254
Name:LIVEWELL COUNSELING LLC
Entity type:Organization
Organization Name:LIVEWELL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDING OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:860-690-9961
Mailing Address - Street 1:41 ATWATER RD
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06019-3022
Mailing Address - Country:US
Mailing Address - Phone:860-690-9961
Mailing Address - Fax:
Practice Address - Street 1:101 RIVER RD
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06019-3244
Practice Address - Country:US
Practice Address - Phone:860-690-9961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty