National Provider Identifier Database

HOLISTIC BEHAVIORAL HEALTH LLC
Professional


Contact Information

HOLISTIC BEHAVIORAL HEALTH, LLC
1700 DIXWELL AVE UNIT D
HAMDEN, CT06514-3147
Phone: 203-604-9009
Fax:
Website:
Specialty Taxonomy Code
* Professional 101YP2500X
Clinical 1041C0700X
Marriage & Family Therapist 106H00000X
Psychiatric/Mental Health 363LP0808X

* Indicates primary specialty

NPI Profile & details for HOLISTIC BEHAVIORAL HEALTH, LLC

NPI Number 1902308604
Legal business name
LBN
HOLISTIC BEHAVIORAL HEALTH, LLC
Authorized official LA'SHONDRA DA CRUZ - (OWNER/CLINICIAN)
Entity Organization
Organization subpart No
Enumeration date 03/08/2018
Last updated 10/29/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • CT License #: 003264
  • CT Medicaid: 1124445663

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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