1609157890 NPI number — POSITIVE OUTLOOKS: THERAPEUTIC CONNECTIONS, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609157890 NPI number — POSITIVE OUTLOOKS: THERAPEUTIC CONNECTIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POSITIVE OUTLOOKS: THERAPEUTIC CONNECTIONS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609157890
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
420 HIGHLAND AVE
Provider Second Line Business Mailing Address:
BLDG B. STE B1
Provider Business Mailing Address City Name:
CHESHIRE
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06410-2527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-931-5566
Provider Business Mailing Address Fax Number:
888-531-8142

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
420 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
BLDG B. STE B1
Provider Business Practice Location Address City Name:
CHESHIRE
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06410-2527
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-931-5566
Provider Business Practice Location Address Fax Number:
888-531-8142
Provider Enumeration Date:
09/01/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SANSOLO
Authorized Official First Name:
ANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PSYCHOTHERAPIST
Authorized Official Telephone Number:
203-931-5566

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  001805 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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