Provider Demographics
NPI:1174543003
Name:ADVANCED THERAPIES, LLC
Entity type:Organization
Organization Name:ADVANCED THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-529-8977
Mailing Address - Street 1:80 SHUNPIKE RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-4401
Mailing Address - Country:US
Mailing Address - Phone:860-529-8977
Mailing Address - Fax:
Practice Address - Street 1:80 SHUNPIKE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-4401
Practice Address - Country:US
Practice Address - Phone:860-529-8977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000682106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004209559Medicaid
CT1952386013OtherNPIENUMERATOR/INDIVIDUAL