Healthcare Provider Details

I. General information

NPI: 1033574355
Provider Name (Legal Business Name): REGENERATION THERAPY AND COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2015
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 MAIN ST
DANIELSON CT
06239-2816
US

IV. Provider business mailing address

245 MAIN ST
DANIELSON CT
06239-2816
US

V. Phone/Fax

Practice location:
  • Phone: 888-316-5221
  • Fax: 866-203-2138
Mailing address:
  • Phone: 888-316-5221
  • Fax: 866-203-2138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. FRIEDRICH C MAURER
Title or Position: OWNER
Credential: LPC
Phone: 860-885-8374