Provider Demographics
NPI:1891914065
Name:CENTER FOR MULTICULTURAL PSYCHOLOGICAL SERVICES,LLC
Entity Type:Organization
Organization Name:CENTER FOR MULTICULTURAL PSYCHOLOGICAL SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGDALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA-ARZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-721-0606
Mailing Address - Street 1:415 SILAS DEANE HWY
Mailing Address - Street 2:SUITE 402
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-2124
Mailing Address - Country:US
Mailing Address - Phone:860-721-0606
Mailing Address - Fax:860-721-0202
Practice Address - Street 1:415 SILAS DEANE HWY
Practice Address - Street 2:SUITE 402
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-2124
Practice Address - Country:US
Practice Address - Phone:860-721-0606
Practice Address - Fax:860-721-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001470101Y00000X
CT000514101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004257045Medicaid