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1093176356 NPI number — HEALING AND TRANSFORMATIVE THERAPY SERVICES LLC

NPI Number: 1093176356
Health Care Provider/Practitioner: HEALING AND TRANSFORMATIVE THERAPY SERVICES LLC

Information about “1093176356” NPI (HEALING AND TRANSFORMATIVE THERAPY SERVICES LLC) exists in 1093176356 in HTML format HTML  |  1093176356 in plain Text format TXT  |  1093176356 in PDF (Portable Document Format) PDF  |  1093176356 in an XML format XML  formats.

NPI Number : 1093176356 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1093176356",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "HEALING AND TRANSFORMATIVE THERAPY SERVICES LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "20 SHORES DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TOLLAND",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06084-2555",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "860-305-8518",
    "MailingAddressFaxNumber": "860-454-7236",
    "FirstLinePracticeLocationAddress": "200 W CENTER ST",
    "SecondLinePracticeLocationAddress": "SUITE C1-2",
    "PracticeLocationAddressCityName": "MANCHESTER",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06040-4864",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "860-305-8518",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/15/2016",
    "LastUpdateDate": "03/15/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ROBINSON",
    "AuthorizedOfficialFirstName": "TRACEY",
    "AuthorizedOfficialMiddleName": "ANNE",
    "AuthorizedOfficialTitle": "MANAGER",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "860-305-8518",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YM0800X",
        "TaxonomyName": "Mental Health Counselor",
        "LicenseNumber": "002003",
        "LicenseNumberStateCode": "CT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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