Reilly, Thomas

Reilly, Thomas is an sole proprietor health care provider with primary practice located at 30 Hazel Terrace Suite 11, Woodbridge CT 06525-2209. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Reilly, Thomas can be contacted via phone (203) 819-7650.

Contact Information

Primary practice address
30 Hazel Terrace Suite 11 Woodbridge CT 06525-2209
Phone: (203) 819-7650
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 002448 Connecticut
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 000951 Connecticut

Profile Details

NPI number 1326316886
LBN Legal business name Reilly, Thomas
Credentials LADC, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2011
Last updated Jul 21st, 2024 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326316886 NPPES
Connecticut MEDICAID 008042339
Connecticut MEDICAID 008038188
Connecticut MEDICAID 008024427
Connecticut MEDICAID 008023170

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