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Contact Information

AUTHENTIC RECOVERY, LLC
1 CARRIAGE PL
SUITE 4
WATERBURY, CT06702-2108
 Phone: 860-805-2267
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counselor

101Y00000X
 

Addiction (Substance Use Disorder)

101YA0400X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Mental Health

101YM0800X
 

Professional

101YP2500X
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for AUTHENTIC RECOVERY, LLC

NPI Number 1285040675
LBN Legal business name AUTHENTIC RECOVERY, LLC
Authorized official JOHN SIMONCELLI - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/07/2014
Last updated 01/12/2015 - About 11 years ago
Identifiers
CT Medicaid 008047242
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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