Provider Demographics
NPI:1902022361
Name:NEW LEARNING THERAPY CENTER
Entity Type:Organization
Organization Name:NEW LEARNING THERAPY CENTER
Other - Org Name:NEW LEARNING CENTER FOR PROF. DEVELOPMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:DIR OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-307-3030
Mailing Address - Street 1:49 JOHN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOUTHPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06890-1436
Mailing Address - Country:US
Mailing Address - Phone:203-307-3030
Mailing Address - Fax:203-255-7486
Practice Address - Street 1:49 JOHN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SOUTHPORT
Practice Address - State:CT
Practice Address - Zip Code:06890-1436
Practice Address - Country:US
Practice Address - Phone:203-307-3030
Practice Address - Fax:203-255-7486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001785103TC0700X
CT0026521041C0700X
CT000015106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02799Medicare ID - Type UnspecifiedCLINIC NUMBER