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AUTHENTIC RECOVERY LLC NPI 1285040675


NPI Information

NPI: 1285040675
Provider Name: AUTHENTIC RECOVERY, LLC
Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
1 CARRIAGE PL
SUITE 4
WATERBURY, CT
ZIP 06702
Phone: (860) 805-2267
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AUTHENTIC RECOVERY, LLC is a counselor in Waterbury, CT. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. AUTHENTIC RECOVERY, LLC NPI is 1285040675. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1 CARRIAGE PL
SUITE 4
WATERBURY, CT
ZIP 06702-108
Phone: (860) 805-2267

The provider's authorized official is John W Simoncelli .
The authorized official title is Executive Director and has the following contact phone number (860) 805-2267.

The enumeration date for this NPI number is 7/7/2014 and was last updated on 1/12/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
3101YM0800XCounselorMental HealthNo
4101YP2500XCounselorProfessionalNo
51041C0700XSocial WorkerClinicalNo
6104100000XSocial WorkerNo
7101Y00000XCounselorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1008047242MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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