Provider Demographics
NPI:1174387864
Name:HEALTHY CONNECTION EAST, LLC
Entity type:Organization
Organization Name:HEALTHY CONNECTION EAST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFF-FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CRC
Authorized Official - Phone:386-405-4156
Mailing Address - Street 1:150 LIMEWOOD PL UNIT 6
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-2669
Mailing Address - Country:US
Mailing Address - Phone:386-405-4156
Mailing Address - Fax:
Practice Address - Street 1:150 LIMEWOOD PL UNIT 6
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-2669
Practice Address - Country:US
Practice Address - Phone:386-405-4156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty