Provider Demographics
NPI:1710406699
Name:GREENWICH ANXIETY INSTITUTE LLC
Entity Type:Organization
Organization Name:GREENWICH ANXIETY INSTITUTE LLC
Other - Org Name:ANXIETY INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-489-0888
Mailing Address - Street 1:75 HOLLY HILL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-2918
Mailing Address - Country:US
Mailing Address - Phone:203-489-0888
Mailing Address - Fax:
Practice Address - Street 1:75 HOLLY HILL LN STE 300
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-2918
Practice Address - Country:US
Practice Address - Phone:203-489-0888
Practice Address - Fax:203-489-0888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY12254997043OtherNPI
CT1174048748OtherNPI