Provider Demographics
NPI:1508456377
Name:ADVANCED TELEPSYCH PLLC
Entity Type:Organization
Organization Name:ADVANCED TELEPSYCH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LEE ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGHURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-401-7484
Mailing Address - Street 1:760 SAYBROOK RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4785
Mailing Address - Country:US
Mailing Address - Phone:888-344-3893
Mailing Address - Fax:
Practice Address - Street 1:760 SAYBROOK RD STE 2
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4785
Practice Address - Country:US
Practice Address - Phone:888-344-3893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty