Provider Demographics
NPI:1689084709
Name:RANDOM THOUGHTS PSYCHOLOGICAL THERAPY P.C.
Entity Type:Organization
Organization Name:RANDOM THOUGHTS PSYCHOLOGICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANBACK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-313-0032
Mailing Address - Street 1:1511 ROUTE 22
Mailing Address - Street 2:SUITE 128
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-4020
Mailing Address - Country:US
Mailing Address - Phone:203-313-0032
Mailing Address - Fax:
Practice Address - Street 1:1511 ROUTE 22
Practice Address - Street 2:SUITE 128
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4020
Practice Address - Country:US
Practice Address - Phone:203-313-0032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0190551103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty