Provider Demographics
NPI:1790233831
Name:LIESE FRANKLIN-ZITZKAT, PSY.D., LLC
Entity Type:Organization
Organization Name:LIESE FRANKLIN-ZITZKAT, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LIESE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZITZKAT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:203-624-0007
Mailing Address - Street 1:291 WHITNEY AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3724
Mailing Address - Country:US
Mailing Address - Phone:203-624-0007
Mailing Address - Fax:203-624-0007
Practice Address - Street 1:291 WHITNEY AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3724
Practice Address - Country:US
Practice Address - Phone:203-624-0007
Practice Address - Fax:203-624-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003112103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty