Provider Demographics
NPI:1528700838
Name:NEW PHASE THERAPY, LLC
Entity type:Organization
Organization Name:NEW PHASE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MANUELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULINO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-601-4590
Mailing Address - Street 1:330 HIGHLAND AVE APT 9C
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-4746
Mailing Address - Country:US
Mailing Address - Phone:860-595-2359
Mailing Address - Fax:
Practice Address - Street 1:330 HIGHLAND AVE APT 9C
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-4746
Practice Address - Country:US
Practice Address - Phone:860-601-4590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty