Provider Demographics
NPI:1679764872
Name:PHILIP H. BROWN DBA CANTERBURY PSYCHOTHERAPY ASSOCIATES
Entity Type:Organization
Organization Name:PHILIP H. BROWN DBA CANTERBURY PSYCHOTHERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:860-546-6959
Mailing Address - Street 1:39 S CANTERBURY RD
Mailing Address - Street 2:P.O. BOX 266
Mailing Address - City:CANTERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06331-1520
Mailing Address - Country:US
Mailing Address - Phone:860-546-6959
Mailing Address - Fax:
Practice Address - Street 1:39 S CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:CANTERBURY
Practice Address - State:CT
Practice Address - Zip Code:06331-1520
Practice Address - Country:US
Practice Address - Phone:860-546-6959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0006121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty