| Holistic Telemental Health | |
|
174 South Rd Ste 112 Enfield CT 06082-4414 | |
| (860) 698-0782 | |
| (413) 455-2708 |
| Full Name | Holistic Telemental Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 174 South Rd Ste 112, Enfield, Connecticut |
| Authorized Official Name and Position | Maria Enid Roman Morales (COUNSELOR) |
| Authorized Official Contact | 4138854335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Telemental Health 174 South Rd Ste 112 Enfield CT 06082-4414 Ph: (860) 698-0782 | Holistic Telemental Health 174 South Rd Ste 112 Enfield CT 06082-4414 Ph: (860) 698-0782 |
| NPI Number | 1891270120 |
|---|---|
| Provider Enumeration Date | 10/02/2018 |
| Last Update Date | 10/02/2018 |
| Medicare PECOS PAC ID | 4183076508 |
|---|---|
| Medicare Enrollment ID | O20240122000560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891270120 | NPI | - | NPPES |
| 1851686000 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Maria Enid Roman Morales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851686000 PECOS PAC ID: 5092167411 Enrollment ID: I20240122000704 |
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