| Holistic Health & Healing Center Llc | |
|
64 Thompson St # A103-104 East Haven CT 06513-5707 | |
| (203) 691-1685 | |
| Not Available |
| Full Name | Holistic Health & Healing Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 64 Thompson St # A103-104, East Haven, Connecticut |
| Authorized Official Name and Position | Tara Paine (OWNER) |
| Authorized Official Contact | 2036911685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Health & Healing Center Llc 64 Thompson St # A103-104 East Haven CT 06513-5707 Ph: (203) 691-1685 | Holistic Health & Healing Center Llc 64 Thompson St # A103-104 East Haven CT 06513-5707 Ph: (203) 691-1685 |
| NPI Number | 1659728012 |
|---|---|
| Provider Enumeration Date | 05/16/2016 |
| Last Update Date | 10/06/2020 |
| Certification Date | 10/06/2020 |
| Medicare PECOS PAC ID | 1557774486 |
|---|---|
| Medicare Enrollment ID | O20210113001757 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659728012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 007720 (Connecticut) | Primary |
| Provider Name | Tara Paine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134408610 PECOS PAC ID: 2961620091 Enrollment ID: I20140902001212 |
| Provider Name | Shaina Boci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376074708 PECOS PAC ID: 9234415779 Enrollment ID: I20170417001279 |
| Provider Name | Jamie Elena Dynderski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700351848 PECOS PAC ID: 2668726837 Enrollment ID: I20181107001975 |
| Provider Name | Nicole Katherine Mcenerney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972264158 PECOS PAC ID: 4486035243 Enrollment ID: I20220726000239 |
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