Holly a. Harry LCSW, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

004004 Issued in CT

Legal business name

HOLLY A. HARRY LCSW, LLC

Practice address

1 Bradley Rd
Suite 205
Woodbridge, CT 06525

Phone

(203) 815-5001

NPI assigned

Jul 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Holly A Neitlich, MSW, LCSW

Title

President

Phone

(203) 815-5001

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1407054612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD",
            "address_2": "SUITE 205",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "06525",
            "telephone_number": "203-815-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD",
            "address_2": "SUITE 205",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "06525",
            "telephone_number": "203-815-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY A. HARRY LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "NEITLICH",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-815-5001",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "CT",
            "license": "004004",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "004004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.