Provider Demographics
NPI:1942500814
Name:FILIPPI, CRISTAN
Entity Type:Individual
Prefix:
First Name:CRISTAN
Middle Name:
Last Name:FILIPPI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 JERICHO DR
Mailing Address - Street 2:
Mailing Address - City:OLD LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06371-1329
Mailing Address - Country:US
Mailing Address - Phone:860-334-8153
Mailing Address - Fax:860-598-9260
Practice Address - Street 1:37 JERICHO DR
Practice Address - Street 2:
Practice Address - City:OLD LYME
Practice Address - State:CT
Practice Address - Zip Code:06371-1329
Practice Address - Country:US
Practice Address - Phone:860-334-8153
Practice Address - Fax:860-598-9260
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1268101YM0800X
102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst