Provider Demographics
NPI:1497989511
Name:PSYCHOTHERAPY ASSOCIATES OF CT, LLC
Entity Type:Organization
Organization Name:PSYCHOTHERAPY ASSOCIATES OF CT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-338-3324
Mailing Address - Street 1:244 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1405
Mailing Address - Country:US
Mailing Address - Phone:860-338-3324
Mailing Address - Fax:
Practice Address - Street 1:244 S MAIN ST
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1405
Practice Address - Country:US
Practice Address - Phone:860-338-3324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health