Healthcare Provider Details

I. General information

NPI: 1891457354
Provider Name (Legal Business Name): TORRINGTON PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2021
Last Update Date: 10/12/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 MAIN ST UNIT 9
TORRINGTON CT
06790-5330
US

IV. Provider business mailing address

79 MAIN ST UNIT 9
TORRINGTON CT
06790-5330
US

V. Phone/Fax

Practice location:
  • Phone: 860-689-9247
  • Fax:
Mailing address:
  • Phone: 860-689-9247
  • 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: MRS. ANNIKA FOSTER
Title or Position: OWNER/PROVIDER
Credential: LCSW
Phone: 860-672-5893