Provider Demographics
NPI:1275758369
Name:CHOVITZ, FRANK J (MS,LADC)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:J
Last Name:CHOVITZ
Suffix:
Gender:M
Credentials:MS,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 HIGHLAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2525
Mailing Address - Country:US
Mailing Address - Phone:203-215-6125
Mailing Address - Fax:203-288-7485
Practice Address - Street 1:408 HIGHLAND AVE STE A
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2525
Practice Address - Country:US
Practice Address - Phone:203-215-6125
Practice Address - Fax:203-288-7485
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000063101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004240008Medicaid