Provider Demographics
NPI:1033562608
Name:PERSONAL HEALING CLINICAL SERVICES LLC
Entity Type:Organization
Organization Name:PERSONAL HEALING CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRIGILA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-989-9504
Mailing Address - Street 1:38 WOODHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1045
Mailing Address - Country:US
Mailing Address - Phone:860-989-9504
Mailing Address - Fax:203-891-5976
Practice Address - Street 1:36 MAIN ST UNIT 8
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-2524
Practice Address - Country:US
Practice Address - Phone:860-989-9504
Practice Address - Fax:203-672-1813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0074081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty