Basic Information
| Provider Information | |||||||||
| NPI: | 1447600234 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KARUNA PSYCHOLOGICAL SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7C PASCO DR | ||||||||
| Address2: | |||||||||
| City: | EAST WINDSOR | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060881707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606231777 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7C PASCO DR | ||||||||
| Address2: | |||||||||
| City: | EAST WINDSOR | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606231777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2016 | ||||||||
| LastUpdateDate: | 06/25/2018 | ||||||||
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| AuthorizedOfficialLastName: | HERNANDEZ-RIVERA | ||||||||
| AuthorizedOfficialFirstName: | ANANDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/PSYCHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 8606231777 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PSY.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TA0700X | 3433 | CT | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging | 103TB0200X | 3433 | CT | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | 103TF0000X | 3433 | CT | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Family | 103TC2200X | 3433 | CT | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | 103TC0700X | 3433 | CT | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.