National Provider Identifier Database

AUTHENTIC RECOVERY LLC
Counselor

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master?s degree and clinical experience and supervision for licensure or certification.


Contact Information

AUTHENTIC RECOVERY, LLC
1 CARRIAGE PL
SUITE 4
WATERBURY, CT06702-2108
Phone: 860-805-2267
Fax:
Website:
Specialty Taxonomy Code
* Counselor 101Y00000X
Addiction (Substance Use Disorder) 101YA0400X
Clinical 1041C0700X
Mental Health 101YM0800X
Professional 101YP2500X
Psychiatric/Mental Health 363LP0808X
Social Worker 104100000X

* Indicates primary specialty

NPI Profile & details for AUTHENTIC RECOVERY, LLC

NPI Number 1285040675
Legal business name
LBN
AUTHENTIC RECOVERY, LLC
Authorized official JOHN SIMONCELLI - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 07/07/2014
Last updated 01/12/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • CT Medicaid: 008047242

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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