Alternative Therapy LLC

Organization Active NPI Professional Counselor · Hamden, CT

NPI 1104120468 · NPPES record last updated Sep 3, 2024

Key facts

NPI
1104120468
Entity type
Organization (NPI type 2)
Primary specialty
Professional Counselor 101YP2500X
Legal business name
ALTERNATIVE THERAPY LLC
Practice address
2911 Dixwell Ave Ste 301
Suite 9
Hamden, CT 06518-3130
Phone
(203) 281-0300
NPI assigned
Dec 30, 2010
Organization subpart
No

Authorized official

Name
Mr. Raul A Avila, MPA,CAGS, NCC, LPC
Title
Director
Phone
(203) 281-0300

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240904000045 CT Part B Supplier - Clinic/Group Practice 4385188630 Receives reassigned benefits from 4 practitioners
Practice locations: Hamden, CT

National Provider Directory

Locations

2911 Dixwell Ave
Ste 301
Hamden, CT 06518
Phone (203) 281-0300

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
101YA0400X
Professional Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
101YP2500X Yes
Psychologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
103T00000X
Clinical Social Worker
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1041C0700X
Marriage & Family Therapist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
106H00000X

Addresses

Primary practice location

2911 Dixwell Ave Ste 301
Suite 9
Hamden, CT 06518-3130

Mailing address

2911 Dixwell Ave Ste 301
Suite 9
Hamden, CT 06518-3130
Phone (203) 281-0300

Other names

  • Alternative Therapy, LLC Former legal business name

Other providers in Hamden, CT

All providers in Hamden, CT · Professional Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.