Provider Demographics
NPI:1316551104
Name:RESILIENT SPIRIT PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:RESILIENT SPIRIT PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-467-0770
Mailing Address - Street 1:515 CENTERPOINT DR STE 305
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-7570
Mailing Address - Country:US
Mailing Address - Phone:860-965-4954
Mailing Address - Fax:
Practice Address - Street 1:515 CENTERPOINT DR STE 305
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-7570
Practice Address - Country:US
Practice Address - Phone:860-467-0770
Practice Address - Fax:860-467-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health