Healthcare Provider Details

I. General information

NPI: 1104581081
Provider Name (Legal Business Name): WHOLISTIC PERSPECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2021
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 W JOHNSON AVE
CHESHIRE CT
06410-4531
US

IV. Provider business mailing address

615 W JOHNSON AVE STE 202
CHESHIRE CT
06410-4532
US

V. Phone/Fax

Practice location:
  • Phone: 860-398-9627
  • Fax:
Mailing address:
  • Phone: 860-398-9627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ESHA BHARDWAJ
Title or Position: OWNER/PROVIDER
Credential: PMHNP
Phone: 860-398-9627