Provider Demographics
NPI:1669637567
Name:AMATO, LOUIS PAUL I (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:PAUL
Last Name:AMATO
Suffix:I
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:LOUIS
Other - Middle Name:PAUL
Other - Last Name:AMATO
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1767 SUMMER ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5115
Mailing Address - Country:US
Mailing Address - Phone:203-967-9292
Mailing Address - Fax:203-438-1875
Practice Address - Street 1:1767 SUMMER STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5115
Practice Address - Country:US
Practice Address - Phone:203-967-9292
Practice Address - Fax:203-438-1875
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001210101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health