Organization Active NPI

Holistic Psychotherapy Services, LLC

  • Clinical Social Worker
  • Waterbury, CT
National Provider Identifier
1508386350
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HOLISTIC PSYCHOTHERAPY SERVICES, LLC
Practice address
969 W Main St Ste 1D
Waterbury, CT 06708-2667
Phone
(203) 768-9808
Fax
(203) 496-5525
NPI assigned
Jun 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jose Crego, LCSW, LADC
Title
Sole Member
Phone
(203) 768-9808

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

969 W Main St Ste 1D
Waterbury, CT 06708-2667

Mailing address

969 W Main St Ste 1D
Waterbury, CT 06708-2667
Phone (203) 768-9808

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508386350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 W MAIN ST STE 1D",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082667",
            "telephone_number": "203-768-9808",
            "fax_number": "203-496-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 W MAIN ST STE 1D",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082667",
            "telephone_number": "203-768-9808",
            "fax_number": "203-496-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC PSYCHOTHERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CREGO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "203-768-9808",
        "authorized_official_credential": "LCSW, LADC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • 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.