Basic Information
| Provider Information | |||||||||
| NPI: | 1194007930 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSOCIATES IN PSYCHOTHERAPY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 61 CHERRY ST | ||||||||
| Address2: | SUITE C2B | ||||||||
| City: | MILFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064608902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032581876 | ||||||||
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| Practice Location | |||||||||
| Address1: | 61 CHERRY ST | ||||||||
| Address2: | SUITE C2B | ||||||||
| City: | MILFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064608902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032581876 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2011 | ||||||||
| LastUpdateDate: | 09/19/2011 | ||||||||
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| AuthorizedOfficialLastName: | TATROE | ||||||||
| AuthorizedOfficialFirstName: | SANDRA | ||||||||
| AuthorizedOfficialMiddleName: | BALTAZAR | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PROVIDER | ||||||||
| AuthorizedOfficialTelephone: | 2032581876 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 005672 | CT | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.