Provider Demographics
NPI:1306478110
Name:HEALING CONNECTIONS WELLNESS LLC
Entity type:Organization
Organization Name:HEALING CONNECTIONS WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MARROTTE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-424-7419
Mailing Address - Street 1:199 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-2573
Mailing Address - Country:US
Mailing Address - Phone:860-424-7419
Mailing Address - Fax:860-300-3555
Practice Address - Street 1:314 NEW BRITAIN RD STE C
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-5306
Practice Address - Country:US
Practice Address - Phone:860-580-9270
Practice Address - Fax:860-300-3555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008074804Medicaid