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:
Health care specialties
Specialty | Code | License # | 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 last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1326316886 | NPPES |
Connecticut | MEDICAID | 008042339 | |
Connecticut | MEDICAID | 008038188 | |
Connecticut | MEDICAID | 008024427 | |
Connecticut | MEDICAID | 008023170 |
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