Provider Demographics
NPI:1487478145
Name:SUPPORTIVE CONNECTION COUNSELING, P.L.L.C.
Entity type:Organization
Organization Name:SUPPORTIVE CONNECTION COUNSELING, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HASBROUCK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-236-1789
Mailing Address - Street 1:1049 ROBERTSON ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3926
Mailing Address - Country:US
Mailing Address - Phone:970-236-1789
Mailing Address - Fax:970-792-8502
Practice Address - Street 1:1049 ROBERTSON ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3926
Practice Address - Country:US
Practice Address - Phone:970-236-1789
Practice Address - Fax:970-792-8502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty