Basic Information
| Provider Information | |||||||||
| NPI: | 1225577331 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED TREATMENT SOLUTIONS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 270642 | ||||||||
| Address2: | |||||||||
| City: | WEST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061270642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668876864 | ||||||||
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| Practice Location | |||||||||
| Address1: | 270 FARMINGTON AVE STE 328 | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060321909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668876864 | ||||||||
| FaxNumber: | 8668876864 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2017 | ||||||||
| LastUpdateDate: | 11/05/2019 | ||||||||
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| AuthorizedOfficialLastName: | MOUTINHO | ||||||||
| AuthorizedOfficialFirstName: | JIMMY | ||||||||
| AuthorizedOfficialMiddleName: | PINTO | ||||||||
| AuthorizedOfficialTitleorPosition: | FOUNDER/DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8668876864 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MS LPC LADC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 2231 | CT | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | 797 | CT | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 103TC0700X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical | 1041C0700X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 101Y00000X | 797 | CT | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor |
No ID Information.