Provider Demographics
NPI:1861296055
Name:ROOT & REACH PROFESSIONAL LTD LIABILITY CO
Entity type:Organization
Organization Name:ROOT & REACH PROFESSIONAL LTD LIABILITY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATELYN MORIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH-BRESKY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:440-223-7123
Mailing Address - Street 1:44 GREENWAY ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-1318
Mailing Address - Country:US
Mailing Address - Phone:440-223-7123
Mailing Address - Fax:
Practice Address - Street 1:44 GREENWAY ST
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517-1318
Practice Address - Country:US
Practice Address - Phone:440-223-7123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty