Provider Demographics
NPI:1043898067
Name:OMNI HEALING LLC
Entity Type:Organization
Organization Name:OMNI HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATASA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZAREVIC
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-992-6594
Mailing Address - Street 1:65 PINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-2705
Mailing Address - Country:US
Mailing Address - Phone:860-992-6594
Mailing Address - Fax:
Practice Address - Street 1:12 MAPLE ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-2292
Practice Address - Country:US
Practice Address - Phone:860-992-6594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty