Provider Demographics
NPI:1073013041
Name:VIANA BEHAVIORAL HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:VIANA BEHAVIORAL HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURCIOS-COTTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-255-4379
Mailing Address - Street 1:16 BRACE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1825
Mailing Address - Country:US
Mailing Address - Phone:860-255-4379
Mailing Address - Fax:
Practice Address - Street 1:16 BRACE RD FL 2
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1825
Practice Address - Country:US
Practice Address - Phone:860-255-4379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-16
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8.003714103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty