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General NPI Number Information
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NPI Number | 1578261228
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Entity Type | Organization
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Legal Business Name | INSTILLNESS THERAPY LLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 1138 W MAIN ST
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City | WATERBURY
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State | CT
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Zip | 06708-2730
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Country | US
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Telephone | 203-707-1291
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Fax |
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Provider Business Mailing Address
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Address Line | 7 HAMILTON LN
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City | WEATOGUE
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State | CT
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Zip | 06089-9764
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Country | US
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Telephone | 860-593-9019
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LAUREN CREMENS
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Credential | LPC
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Telephone | 860-593-9019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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