Provider Demographics
NPI:1104221019
Name:HOLISTIC PSYCHOTHERAPY
Entity Type:Organization
Organization Name:HOLISTIC PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JANINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAURO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-960-9672
Mailing Address - Street 1:198 ANNS FARM RD.
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518
Mailing Address - Country:US
Mailing Address - Phone:973-960-9672
Mailing Address - Fax:
Practice Address - Street 1:35 BOSTON ST.
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437
Practice Address - Country:US
Practice Address - Phone:973-960-9672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002022101YP2500X
CT88111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty