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HOLISTIC ATHLETE LLC NPI 1932834926


NPI Information

NPI: 1932834926
Provider Name: HOLISTIC ATHLETE LLC
Classification: Psychologist - 103TE1100X
Entity Type: Organization

Specialization: Exercise & Sports

Address:
24B ROSEMARY LN
MIDDLEFIELD, CT
ZIP 06455
Phone: (860) 877-6093
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HOLISTIC ATHLETE LLC is an exercise and sports psychologist in Middlefield, CT. The provider is a psychologist with a proficiency in sports psychology that uses psychological knowledge and skills to address optimal performance and well-being of athletes, developmental and social aspects of sports participation, and systemic issues associated with sports settings and organizations. APA recognizes sport psychology as a proficiency acquired after a doctoral degree in one of the primary areas of psychology and licensure as a psychologist. This proficiency does not include those who have earned a doctoral degree in sport psychology but are not licensed psychologists. HOLISTIC ATHLETE LLC NPI is 1932834926. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

24B ROSEMARY LN
MIDDLEFIELD, CT
ZIP 06455-041
Phone: (860) 877-6093

The provider's authorized official is Zachary Etter .
The authorized official title is Ceo and has the following contact phone number (860) 877-6093.

The enumeration date for this NPI number is 7/22/2022 and was last updated on 7/22/2022.


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
1103TC1900XPsychologistCounselingNo
2103TE1100XPsychologistExercise & SportsYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.