| Tr Counseling & Wellness Llc | |
|
30 Hazel Terrace Suite 11 Woodbridge CT 06525-2240 | |
| (203) 819-7650 | |
| Not Available |
| Full Name | Tr Counseling & Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 30 Hazel Terrace, Woodbridge, Connecticut |
| Authorized Official Name and Position | Thomas James Reilly (OWNER THERAPIST) |
| Authorized Official Contact | 2038197650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tr Counseling & Wellness Llc 30 Hazel Ter Ste 11 Woodbridge CT 06525-2240 Ph: (203) 819-7650 | Tr Counseling & Wellness Llc 30 Hazel Terrace Suite 11 Woodbridge CT 06525-2240 Ph: (203) 819-7650 |
| NPI Number | 1629494232 |
|---|---|
| Provider Enumeration Date | 03/07/2014 |
| Last Update Date | 07/22/2024 |
| Certification Date | 07/22/2024 |
| Medicare PECOS PAC ID | 4880939065 |
|---|---|
| Medicare Enrollment ID | O20181217000074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629494232 | NPI | - | NPPES |
| 008038188 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 000951 (Connecticut) | Secondary |
| 101YM0800X | Counselor - Mental Health | 002448 (Connecticut) | Primary |
| Provider Name | Charles F Kirby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306094297 PECOS PAC ID: 0345415576 Enrollment ID: I20161123000156 |
| Provider Name | Donald R Sirry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558753897 PECOS PAC ID: 0941589485 Enrollment ID: I20161128001118 |
| Provider Name | Thomas James Reilly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326316886 PECOS PAC ID: 7416292693 Enrollment ID: I20240306000585 |
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