Healthcare Provider Details
I. General information
NPI: 1881527141
Provider Name (Legal Business Name): LAUGHING MOON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1227 FARMINGTON AVE
BERLIN CT
06037-2301
US
IV. Provider business mailing address
8 JANET DR FL 2
NEW BRITAIN CT
06053-1707
US
V. Phone/Fax
- Phone: 860-888-2286
- Fax:
- Phone: 860-888-2286
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALYSSA
KNIERING
Title or Position: THERAPIST/OWNER
Credential: LPC
Phone: 860-888-2286