1740396936 NPI number — KNOSIS COUNSELING AND PSYCHOTHERAPY LLC

Table of content: (NPI 1740396936)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740396936 NPI number — KNOSIS COUNSELING AND PSYCHOTHERAPY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNOSIS COUNSELING AND PSYCHOTHERAPY 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:
1740396936
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41 KENOSIA AVE
Provider Second Line Business Mailing Address:
STE 302
Provider Business Mailing Address City Name:
DANBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06810-7360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-743-9012
Provider Business Mailing Address Fax Number:
203-743-9012

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 KENOSIA AVE
Provider Second Line Business Practice Location Address:
STE 302
Provider Business Practice Location Address City Name:
DANBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06810-7360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-743-9012
Provider Business Practice Location Address Fax Number:
203-743-9012
Provider Enumeration Date:
08/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STONE
Authorized Official First Name:
LYNNE
Authorized Official Middle Name:
CHERYL
Authorized Official Title or Position:
OWNER/MANAGING MEMBER
Authorized Official Telephone Number:
203-743-9012

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  004844 , 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)

  • Identifier: 0007204577 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 7349733 . This is a "VALUE OPTIONS-EMPIRE GHI" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 140004844CT03 . This is a "ANTHEM BH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2068783 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 275249 . This is a "MHN/HEALTHNET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P2159350 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 11403041 . This is a "CAQH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 163859 . This is a "VALUE OPTIONS-PITNEY BOWE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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