| Holistic Psychotherapy Services, Llc | |
|
969 W Main St Ste 1d Waterbury CT 06708-2667 | |
| (203) 768-9808 | |
| (203) 496-5525 |
| Full Name | Holistic Psychotherapy Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 969 W Main St Ste 1d, Waterbury, Connecticut |
| Authorized Official Name and Position | Jose Crego (SOLE MEMBER) |
| Authorized Official Contact | 2037689808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Psychotherapy Services, Llc 969 W Main St Ste 1d Waterbury CT 06708-2667 Ph: (203) 768-9808 | Holistic Psychotherapy Services, Llc 969 W Main St Ste 1d Waterbury CT 06708-2667 Ph: (203) 768-9808 |
| NPI Number | 1508386350 |
|---|---|
| Provider Enumeration Date | 06/22/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 6901170919 |
|---|---|
| Medicare Enrollment ID | O20170914001180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508386350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kimberly A Rinko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104267798 PECOS PAC ID: 7416264429 Enrollment ID: I20150923000783 |
| Provider Name | Jose E Crego |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245594159 PECOS PAC ID: 4880902394 Enrollment ID: I20151002001649 |
| Provider Name | Tanya L. Bingham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851498174 PECOS PAC ID: 4981984366 Enrollment ID: I20161130000974 |
| Provider Name | Jacquelyn Crego |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760720759 PECOS PAC ID: 6800171737 Enrollment ID: I20170316000351 |
| Provider Name | Marissa Rose Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710354527 PECOS PAC ID: 0840534079 Enrollment ID: I20181129000369 |
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