Healthcare Provider Details

I. General information

NPI: 1528889813
Provider Name (Legal Business Name): SEEDS OF GROWTH PSYCHIATRIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 OLD NORTH RD
BARKHAMSTED CT
06063-3459
US

IV. Provider business mailing address

65 OLD NORTH RD
BARKHAMSTED CT
06063-3459
US

V. Phone/Fax

Practice location:
  • Phone: 860-508-9938
  • Fax: 855-309-9413
Mailing address:
  • Phone: 860-508-9938
  • Fax: 855-309-9413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAWN ERLINGSON
Title or Position: PROVIDER/OWNER
Credential: PMHNP
Phone: 860-508-9938