Provider Demographics
NPI:1376837583
Name:BARBARA GRETEN PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:BARBARA GRETEN PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH AND TRAUMA THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRETEN
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV, MSW, LCSW
Authorized Official - Phone:203-859-2111
Mailing Address - Street 1:85 BUTTERNUT DR
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-3509
Mailing Address - Country:US
Mailing Address - Phone:203-859-2111
Mailing Address - Fax:203-630-1177
Practice Address - Street 1:200 ORCHARD ST
Practice Address - Street 2:SUITE 301
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5363
Practice Address - Country:US
Practice Address - Phone:203-859-2111
Practice Address - Fax:203-630-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
CT0073121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty