Provider Demographics
NPI:1598300212
Name:AB PSYCHOTHERAPY AND ADDICTION SERVICES
Entity Type:Organization
Organization Name:AB PSYCHOTHERAPY AND ADDICTION SERVICES
Other - Org Name:AB PSYCHOTHERAPY AND ADDICTION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:WILFRED
Authorized Official - Last Name:BONIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LPC
Authorized Official - Phone:401-206-1531
Mailing Address - Street 1:7 FRANCES ST
Mailing Address - Street 2:
Mailing Address - City:UNCASVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06382-1015
Mailing Address - Country:US
Mailing Address - Phone:401-206-1531
Mailing Address - Fax:
Practice Address - Street 1:567 VAUXHALL STREET EXT STE 207
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-4332
Practice Address - Country:US
Practice Address - Phone:401-206-1531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-18
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty