Provider Demographics
NPI:1285442558
Name:LAGOM WELLNESS COUNSELING LLC
Entity type:Organization
Organization Name:LAGOM WELLNESS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPONT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:727-631-7259
Mailing Address - Street 1:29 BETTS PL
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06855-1802
Mailing Address - Country:US
Mailing Address - Phone:727-631-7259
Mailing Address - Fax:
Practice Address - Street 1:29 BETTS PL
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06855-1802
Practice Address - Country:US
Practice Address - Phone:727-631-7259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)