Provider Demographics
NPI:1346550977
Name:NEW ENGLAND CENTER FOR C.B.T. & PSYCHIATRY
Entity Type:Organization
Organization Name:NEW ENGLAND CENTER FOR C.B.T. & PSYCHIATRY
Other - Org Name:NEW ENGLAND BEHAVIORAL HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:CORDIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LCPC
Authorized Official - Phone:860-430-5515
Mailing Address - Street 1:110 NATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4371
Mailing Address - Country:US
Mailing Address - Phone:860-430-5515
Mailing Address - Fax:860-430-9754
Practice Address - Street 1:110 NATIONAL DR
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4371
Practice Address - Country:US
Practice Address - Phone:860-430-5515
Practice Address - Fax:860-430-9754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-16
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001420101YP2500X, 103TB0200X, 251S00000X, 261QM0801X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health