Provider Demographics
NPI:1194158345
Name:THERAPY ON THE RUN
Entity type:Organization
Organization Name:THERAPY ON THE RUN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRESHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-618-3236
Mailing Address - Street 1:1 TORRINGTON OFFICE PLZ
Mailing Address - Street 2:SUITE 211
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-3854
Mailing Address - Country:US
Mailing Address - Phone:860-618-3236
Mailing Address - Fax:860-201-5716
Practice Address - Street 1:1 TORRINGTON OFFICE PLZ
Practice Address - Street 2:SUITE 211
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3854
Practice Address - Country:US
Practice Address - Phone:860-618-3236
Practice Address - Fax:860-201-5716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001379101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty