Provider Demographics
NPI:1497129407
Name:TARTT, JASON (LCSW)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:TARTT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BALANCE THERAPY SERVICES, LLC
Mailing Address - Street 2:32 HIGHLAND TERRACE
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053
Mailing Address - Country:US
Mailing Address - Phone:860-989-5437
Mailing Address - Fax:
Practice Address - Street 1:1224 MILL STREET
Practice Address - Street 2:BLDG. B SUITE 113
Practice Address - City:EAST BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06023-0602
Practice Address - Country:US
Practice Address - Phone:860-748-9443
Practice Address - Fax:860-371-3840
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-16
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT119981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT11998OtherLCSW LICENSE