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Contact Information

HOLISTIC BEHAVIORAL HEALTH, LLC
1700 DIXWELL AVE UNIT D
HAMDEN, CT06514-3147
 Phone: 203-604-9009
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Marriage & Family Therapist

106H00000X
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for HOLISTIC BEHAVIORAL HEALTH, LLC

NPI Number 1902308604
LBN Legal business name HOLISTIC BEHAVIORAL HEALTH, LLC
Authorized official LA'SHONDRA DA CRUZ - (OWNER/CLINICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 03/08/2018
Last updated 10/29/2022 - About 4 years ago
Identifiers
CT License # 003264
CT Medicaid 1124445663
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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