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General NPI Number Information
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NPI Number | 1902790785
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Entity Type | Organization
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Legal Business Name | ALCHEMY THERAPY, LLC
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 13 PARK ST STE 4
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City | VERNON
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State | CT
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Zip | 06066-3281
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Country | US
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Telephone | 860-316-9620
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Fax |
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Provider Business Mailing Address
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Address Line | 125 MAIN ST APT G
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City | MANCHESTER
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State | CT
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Zip | 06042-3166
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GARY KOVACHI
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Credential | LMFT
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Telephone | 860-316-9620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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