Provider Demographics
NPI:1033443882
Name:PSYCHIATRIC CARE CONSULTANTS LLC
Entity Type:Organization
Organization Name:PSYCHIATRIC CARE CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KISHORCHANDRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GONSAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-562-0223
Mailing Address - Street 1:111 PARK ST
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5412
Mailing Address - Country:US
Mailing Address - Phone:203-562-0223
Mailing Address - Fax:203-777-4226
Practice Address - Street 1:111 PARK ST
Practice Address - Street 2:SUITE 1G
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5412
Practice Address - Country:US
Practice Address - Phone:203-562-0223
Practice Address - Fax:203-777-4226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT036772261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health