Provider Demographics
NPI:1073916490
Name:TRANSITIONS THERAPY, LLC
Entity Type:Organization
Organization Name:TRANSITIONS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-222-2529
Mailing Address - Street 1:4 TUMBLE BROOK DR
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-5013
Mailing Address - Country:US
Mailing Address - Phone:860-222-2529
Mailing Address - Fax:860-760-6136
Practice Address - Street 1:36B CHURCH ST
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-1860
Practice Address - Country:US
Practice Address - Phone:860-222-2529
Practice Address - Fax:860-760-6136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007890251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008038971Medicaid