Provider Demographics
NPI:1942965090
Name:2ASSUREUS
Entity Type:Organization
Organization Name:2ASSUREUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAJAVON
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-759-5097
Mailing Address - Street 1:87 BARRY PL
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1207
Mailing Address - Country:US
Mailing Address - Phone:860-759-5097
Mailing Address - Fax:
Practice Address - Street 1:21 CHARTER OAK AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1801
Practice Address - Country:US
Practice Address - Phone:860-759-5097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty