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General NPI Number Information
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NPI Number | 1104221019
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Entity Type | Organization
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Legal Business Name | HOLISTIC PSYCHOTHERAPY
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Dates
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Enumeration Date | 11/04/2014
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Last Update Date | 06/29/2015
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Provider Practice Location Address
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Address Line | 35 BOSTON ST.
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City | GUILFORD
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State | CT
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Zip | 06437
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Country | US
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Telephone | 973-960-9672
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Fax |
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Provider Business Mailing Address
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Address Line | 198 ANNS FARM RD.
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City | HAMDEN
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State | CT
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Zip | 06518
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Country | US
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Telephone | 973-960-9672
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | JANINA TAURO
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Credential | LCSW
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Telephone | 973-960-9672
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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 | 8811
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 002022
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License Number State | CT
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