Provider Demographics
NPI:1902614746
Name:RHINEHART, TANGERINE (MS, LADC)
Entity type:Individual
Prefix:
First Name:TANGERINE
Middle Name:
Last Name:RHINEHART
Suffix:
Gender:F
Credentials:MS, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAND ST STE 2G
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-1908
Mailing Address - Country:US
Mailing Address - Phone:203-901-1548
Mailing Address - Fax:
Practice Address - Street 1:100 GRAND ST STE G
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1908
Practice Address - Country:US
Practice Address - Phone:203-901-1548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1589101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty