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General NPI Number Information
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NPI Number | 1316222342
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Entity Type | Organization
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Legal Business Name | PARTNERS IN THERAPY
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Dates
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Enumeration Date | 10/21/2011
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 1750 ELLINGTON RD BLDG 3
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-2746
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Country | US
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Telephone | 860-882-7299
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9500
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City | BOLTON
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State | CT
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Zip | 06043-9500
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Country | US
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Telephone | 860-882-7299
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Fax | 860-533-1926
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Authorized Official
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Title or Position | OWNER
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Name | MR. PETER MICHAEL COVELLO
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Credential | LMFT
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Telephone | 860-882-7299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 001465
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License Number State | CT
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