Provider Demographics
NPI:1073575221
Name:OHANESIAN, PAUL GEORGE (MFT)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:GEORGE
Last Name:OHANESIAN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 NEW BRITAIN RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06037-1360
Mailing Address - Country:US
Mailing Address - Phone:860-827-1375
Mailing Address - Fax:860-342-1639
Practice Address - Street 1:211 NEW BRITAIN ROAD
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:CT
Practice Address - Zip Code:06037-3168
Practice Address - Country:US
Practice Address - Phone:860-342-1287
Practice Address - Fax:562-502-4235
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000201106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist