Provider Demographics
NPI:1295869196
Name:ADVANCED SOLUTIONS THERAPY CENTER LLC
Entity type:Organization
Organization Name:ADVANCED SOLUTIONS THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MONOCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-755-0707
Mailing Address - Street 1:1138 WEST MAIN ST
Mailing Address - Street 2:ADVANCED SOLUTIONS THERAPY CENTER LLC
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-755-0707
Mailing Address - Fax:203-755-9275
Practice Address - Street 1:1138 WEST MAIN ST
Practice Address - Street 2:ADVANCED SOLUTIONS THERAPY CENTER LLC
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-755-0707
Practice Address - Fax:203-755-9275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0004361LCSW1041C0700X
CT000782LMFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004255156Medicaid
CT004254041Medicaid