Therapeutic Alliance of Connecticut, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

7027 Issued in CT

Legal business name

THERAPEUTIC ALLIANCE OF CONNECTICUT, LLC

Practice address

174 South Rd Ste 125
Enfield, CT 06082-4414

Phone

(860) 966-1004

Fax

(860) 788-4090

NPI assigned

Jun 12, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Julio Rene Duran Jr., PMHNPNPI 1598291353

Title

Owner

Phone

(860) 966-1004

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julio Rene Duran Jr., APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • New Britain, CT
  • NPI 1598291353
  NPD (past) Authorized official

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1467982504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 SOUTH RD STE 125",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824414",
            "telephone_number": "860-966-1004",
            "fax_number": "860-788-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 SOUTH RD STE 125",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824414",
            "telephone_number": "860-966-1004",
            "fax_number": "860-788-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC ALLIANCE OF CONNECTICUT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DURAN",
        "authorized_official_first_name": "JULIO",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-966-1004",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "7027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Enfield, CT
• Providers in Enfield, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.