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General NPI Number Information
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NPI Number | 1033562608
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Entity Type | Organization
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Legal Business Name | PERSONAL HEALING CLINICAL SERVICES LLC
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 36 MAIN ST UNIT 8
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City | EAST HAVEN
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State | CT
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Zip | 06512-2524
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Country | US
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Telephone | 860-989-9504
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Fax | 203-672-1813
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Provider Business Mailing Address
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Address Line | 38 WOODHAVEN RD
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City | ROCKY HILL
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State | CT
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Zip | 06067-1045
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Country | US
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Telephone | 860-989-9504
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Fax | 203-891-5976
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Authorized Official
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Title or Position | OWNER
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Name | LAURA J TRIGILA
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Credential | LCSW
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Telephone | 860-989-9504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 007408
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License Number State | CT
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