Healthcare Provider Details

I. General information

NPI: 1225366131
Provider Name (Legal Business Name): THE HEALING CONNECTION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2009
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 UNIVERSITY AVE
ROCHESTER NY
14607-1622
US

IV. Provider business mailing address

FAIRPORT OFFICE PARK SUITE 1000D
FAIRPORT NY
14450-2003
US

V. Phone/Fax

Practice location:
  • Phone: 585-641-0281
  • Fax: 585-641-0286
Mailing address:
  • Phone: 585-641-0281
  • Fax: 585-641-0286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number8171001A
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number8171001A
License Number StateNY

VIII. Authorized Official

Name: DR. MARY TANTILLO
Title or Position: CEO/CLINICAL DIRECTOR
Credential: PHD PMHCNS-BC
Phone: 585-641-0281