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NPI Code Detail

MEDICARE: THE HEALING CONNECTION, INC.

MEDICARE: THE HEALING CONNECTION, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0855XAdolescent and Children Mental Health Clinic/Center8171001ANY
2261QM0850XAdult Mental Health Clinic/Center8171001ANY

General Provider Information

NPI Number : 1225366131
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE HEALING CONNECTION, INC.
Provider Business Mailing Address
First Line : FAIRPORT OFFICE PARK
Second Line : SUITE 1000D
City : FAIRPORT
State : NY
Zip : 14450-2003
Country : US
Telephone Number : 585-641-0281
Fax Number : 585-641-0286
Provider Business Practice Location Address
First Line : 1320 UNIVERSITY AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14607-1622
Country : US
Telephone Number : 585-641-0281
Fax Number : 585-641-0286
Authorized Official
Title or Position : CEO/CLINICAL DIRECTOR
Name : DR. MARY TANTILLO
Credential : PHD PMHCNS-BC
Telephone Number : 585-641-0281
Provider Enumeration Date : 12/04/2009
Last Update Date : 08/01/2025

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