MEDICARE: POSITIVE SOLUTIONS THERAPY, LLC

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1518421759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVE SOLUTIONS THERAPY, LLC

Provider Business Mailing Address
First Line	:	53 RED CLOVER CIR
Second Line	:
City	:	MIDDLETOWN
State	:	CT
Zip	:	06457-4915
Country	:	US
Telephone Number	:	347-200-8388
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 CENTERPOINT DR
Second Line	:
City	:	MIDDLETOWN
State	:	CT
Zip	:	06457-7570
Country	:	US
Telephone Number	:	347-200-8388
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER & MEMBER
Name	:	MRS. TOWANNA PHILLIP
Credential	:	LCSW
Telephone Number	:	347-200-8388

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	01/22/2019

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