Provider Demographics
NPI:1639992845
Name:TH PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:TH PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:TRINITY
Authorized Official - Middle Name:
Authorized Official - Last Name:HASWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-491-0452
Mailing Address - Street 1:65 REDDING RD UNIT 807
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06829
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 PORTLAND HILL ROAD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CT
Practice Address - Zip Code:06896
Practice Address - Country:US
Practice Address - Phone:203-491-0452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health