Provider Demographics
NPI:1659614279
Name:COMPREHENSIVE PSYCHIATRIC SOLUTIONS LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PSYCHIATRIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-770-3018
Mailing Address - Street 1:666 GLENBROOK RD STE 1
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06906-1439
Mailing Address - Country:US
Mailing Address - Phone:203-770-3018
Mailing Address - Fax:203-569-3149
Practice Address - Street 1:666 GLENBROOK RD STE 1
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06906-1439
Practice Address - Country:US
Practice Address - Phone:203-770-3018
Practice Address - Fax:203-569-3149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0481972084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTNPPESOtherNPI 1891787859
CT11291775OtherCAQH
CT048197OtherMEDICAL LICENSE STATE OF CT
CT048197OtherMEDICAL LICENSE STATE OF CT