Provider Demographics
NPI:1689121378
Name:TAPROOT INTEGRATIVE CARE FOR HOLISTIC HEALTH
Entity Type:Organization
Organization Name:TAPROOT INTEGRATIVE CARE FOR HOLISTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-930-6745
Mailing Address - Street 1:56 ARBOR ST STE 106
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-1223
Mailing Address - Country:US
Mailing Address - Phone:860-930-6745
Mailing Address - Fax:860-967-0343
Practice Address - Street 1:56 ARBOR ST STE 106
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1223
Practice Address - Country:US
Practice Address - Phone:860-930-6745
Practice Address - Fax:860-967-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty