Healthcare Provider Details

I. General information

NPI: 1225577331
Provider Name (Legal Business Name): ADVANCED TREATMENT SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 FARMINGTON AVE STE 328
FARMINGTON CT
06032-1909
US

IV. Provider business mailing address

PO BOX 270642
WEST HARTFORD CT
06127-0642
US

V. Phone/Fax

Practice location:
  • Phone: 866-887-6864
  • Fax: 866-887-6864
Mailing address:
  • Phone: 866-887-6864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number797
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2231
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number797
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. JIMMY PINTO MOUTINHO
Title or Position: FOUNDER/DIRECTOR
Credential: MS LPC LADC
Phone: 866-887-6864