Healthcare Provider Details

I. General information

NPI: 1861148215
Provider Name (Legal Business Name): QUINTESSENTIAL REASONING ,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 02/24/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 WASHINGTON AVENUE 10S 2ND FLOOR
HAMDEN CT
06518-3025
US

IV. Provider business mailing address

259 WASHINGTON AVENUE 10S 2ND FLOOR
HAMDEN CT
06518-3025
US

V. Phone/Fax

Practice location:
  • Phone: 475-222-5711
  • Fax:
Mailing address:
  • Phone: 475-222-5711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CENITA L CRUZ
Title or Position: MANAGER
Credential: LCSW LDAC
Phone: 475-222-5711