Provider Demographics
NPI:1679869978
Name:ANASTA KYDES-HARMONY OF THE MIND, BODY, & SOUL LLC
Entity type:Organization
Organization Name:ANASTA KYDES-HARMONY OF THE MIND, BODY, & SOUL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:P
Authorized Official - Last Name:KYDES
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LPC
Authorized Official - Phone:203-318-4514
Mailing Address - Street 1:111 EAST AVE
Mailing Address - Street 2:SUITE 313
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 EAST AVE
Practice Address - Street 2:SUITE 313
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5014
Practice Address - Country:US
Practice Address - Phone:203-318-4514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001772101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty