| Resilient Spirit Psychotherapy Llc | |
|
515 Centerpoint Dr Ste 305 Middletown CT 06457-7570 | |
| (860) 467-0770 | |
| (860) 467-0660 |
| Full Name | Resilient Spirit Psychotherapy Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 515 Centerpoint Dr Ste 305, Middletown, Connecticut |
| Authorized Official Name and Position | Traci Howland (PRINCIPAL/OWNER) |
| Authorized Official Contact | 8604670770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resilient Spirit Psychotherapy Llc 515 Centerpoint Dr Ste 305 Middletown CT 06457-7570 Ph: (860) 965-4954 | Resilient Spirit Psychotherapy Llc 515 Centerpoint Dr Ste 305 Middletown CT 06457-7570 Ph: (860) 467-0770 |
| NPI Number | 1316551104 |
|---|---|
| Provider Enumeration Date | 08/31/2020 |
| Last Update Date | 11/12/2020 |
| Certification Date | 11/12/2020 |
| Medicare PECOS PAC ID | 7719325828 |
|---|---|
| Medicare Enrollment ID | O20240409003400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316551104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Traci Sue Howland |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1053964221 PECOS PAC ID: 8628416732 Enrollment ID: I20240410000183 |
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