Healthcare Provider Details

I. General information

NPI: 1679663082
Provider Name (Legal Business Name): THE HEALING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 N MAIN ST SUITE 108
WEST HARTFORD CT
06107-1932
US

IV. Provider business mailing address

12 N MAIN ST SUITE 108
WEST HARTFORD CT
06107-1932
US

V. Phone/Fax

Practice location:
  • Phone: 860-561-8727
  • Fax: 860-561-8424
Mailing address:
  • Phone: 860-561-8727
  • Fax: 860-561-8424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DAVID N GREENFIELD
Title or Position: PRINCIPAL
Credential: PHD
Phone: 860-561-8727