MEDICARE: THE HEALING CENTER 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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1679663082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HEALING CENTER LLC

Provider Business Mailing Address
First Line	:	12 N MAIN ST
Second Line	:	SUITE 108
City	:	WEST HARTFORD
State	:	CT
Zip	:	06107-1932
Country	:	US
Telephone Number	:	860-561-8727
Fax Number	:	860-561-8424

Provider Business Practice Location Address
First Line	:	12 N MAIN ST
Second Line	:	SUITE 108
City	:	WEST HARTFORD
State	:	CT
Zip	:	06107-1932
Country	:	US
Telephone Number	:	860-561-8727
Fax Number	:	860-561-8424

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	DAVID N GREENFIELD
Credential	:	PHD
Telephone Number	:	860-561-8727

Provider Enumeration Date	:	10/14/2006
Last Update Date	:	08/22/2020

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Directions to “THE HEALING CENTER LLC ” Practice Location

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