Provider Demographics
NPI:1528579398
Name:COGNITIVE AND BEHAVIORAL THERAPIES OF RIDGEFIELD, PLLC
Entity Type:Organization
Organization Name:COGNITIVE AND BEHAVIORAL THERAPIES OF RIDGEFIELD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:COURTNEY-SEIDLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-297-8583
Mailing Address - Street 1:100B DANBURY ROAD
Mailing Address - Street 2:SUITE 105B
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100B DANBURY ROAD
Practice Address - Street 2:SUITE 105B
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877
Practice Address - Country:US
Practice Address - Phone:203-297-8583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3604251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health