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General NPI Number Information
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NPI Number | 1942020235
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Entity Type | Organization
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Legal Business Name | SPIRIT SOUL AND BODY CLINICAL SERVICES
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Dates
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Enumeration Date | 10/12/2024
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 303 ARCH ST
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City | NEW BRITAIN
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State | CT
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Zip | 06051-2520
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Country | US
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Telephone | 860-964-7311
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Fax |
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Provider Business Mailing Address
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Address Line | 303 ARCH ST
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City | NEW BRITAIN
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State | CT
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Zip | 06051-2520
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Country | US
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Telephone | 860-964-7311
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Fax |
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Authorized Official
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Title or Position | LICENSED MASTER SOCIAL WORKER
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Name | ERIC RICHARDS
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Credential | LMSW
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Telephone | 860-881-1347
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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 |
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License Number State |
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