Provider Demographics
NPI:1407398530
Name:HARTFORD PSYCHOTHERAPY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:HARTFORD PSYCHOTHERAPY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ST PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:860-380-0293
Mailing Address - Street 1:43 EDGEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-1120
Mailing Address - Country:US
Mailing Address - Phone:860-380-0293
Mailing Address - Fax:
Practice Address - Street 1:87 CHURCH ST
Practice Address - Street 2:SUITE 304
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-3720
Practice Address - Country:US
Practice Address - Phone:860-251-9379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT940101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty