NPIMap

Organization Active NPI

Holistic Health & Healing Center LLC

  • Clinical Social Worker
  • East Haven, CT
National Provider Identifier
1659728012
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007720 Issued in CT
Legal business name
HOLISTIC HEALTH & HEALING CENTER LLC
Practice address
64 Thompson St # A103-104
East Haven, CT 06513-5707
Phone
(203) 691-1685
NPI assigned
May 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Authorized official

Name
Tara Paine, LCSWNPI 1134408610
Title
Owner
Phone
(203) 691-1685

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 007720 CT Primary

Addresses

Primary practice location

64 Thompson St # A103-104
East Haven, CT 06513-5707

Mailing address

64 Thompson St # A103-104
East Haven, CT 06513-5707
Phone (203) 691-1685

Other practice location 1

901 Farmington Ave
3rd Floor Ste 2
West Hartford, CT 06119-0611
Phone (203) 691-1685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210113001757 CT Part B Supplier - Clinic/Group Practice 1557774486 Receives reassigned benefits from 11 practitioners
Practice locations: East Haven, CT

National Provider Directory

National Provider Directory

Locations

64 Thompson St
#A103104
East Haven, CT 06513
Phone (203) 691-1685

64 Thompson St
Ste A103104
East Haven, CT 06513
Phone (203) 691-1685

451 State St
#A5
North Haven, CT 06473

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1659728012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 THOMPSON ST # A103-104",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065135707",
            "telephone_number": "203-691-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 THOMPSON ST # A103-104",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065135707",
            "telephone_number": "203-691-1685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Farmington Ave",
            "address_2": "3rd Floor Ste 2",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061190611",
            "country_code": "US",
            "telephone_number": "203-691-1685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOLISTIC HEALTH & HEALING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "PAINE",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-691-1685",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.