| Evolve Holistic Therapy Llc | |
|
352 Main St Durham CT 06422-1645 | |
| (860) 464-4600 | |
| (860) 464-4648 |
| Full Name | Evolve Holistic Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 352 Main St, Durham, Connecticut |
| Authorized Official Name and Position | Erin Pfeifer-andrin (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 8604644600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Holistic Therapy Llc 91 Madison Springs Dr Madison CT 06443-2419 Ph: (860) 464-4600 | Evolve Holistic Therapy Llc 352 Main St Durham CT 06422-1645 Ph: (860) 464-4600 |
| NPI Number | 1174179311 |
|---|---|
| Provider Enumeration Date | 08/14/2019 |
| Last Update Date | 09/25/2019 |
| Medicare PECOS PAC ID | 9537499363 |
|---|---|
| Medicare Enrollment ID | O20190923000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174179311 | NPI | - | NPPES |
| 225401801000123 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Erin Pfeifer Andrin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972913937 PECOS PAC ID: 1850651266 Enrollment ID: I20180202002021 |
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