Provider Demographics
| NPI: | 1538530241 |
|---|---|
| Name: | FRESH START THERAPY AND WELLNESS LLC |
| Entity type: | Organization |
| Organization Name: | FRESH START THERAPY AND WELLNESS LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | FOUNDER AND CHIEF EXECUTIVE OFFICER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JENNY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | CURRIE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | LPC AND LPCC |
| Authorized Official - Phone: | 203-293-8554 |
| Mailing Address - Street 1: | 7515 EAGLE TRACE DR |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WESTERVILLE |
| Mailing Address - State: | OH |
| Mailing Address - Zip Code: | 43082-8491 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 203-293-8554 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 7515 EAGLE TRACE DR |
| Practice Address - Street 2: | |
| Practice Address - City: | WESTERVILLE |
| Practice Address - State: | OH |
| Practice Address - Zip Code: | 43082-8491 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 203-293-8554 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2015-10-08 |
| Last Update Date: | 2022-01-12 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| CT | 002771 | 251B00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251B00000X | Agencies | Case Management |