Provider Demographics
NPI:1972712628
Name:WELSH, RALPH S (PHD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:S
Last Name:WELSH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:R
Other - Middle Name:S
Other - Last Name:WELSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD IN PSYCHOLOGY
Mailing Address - Street 1:PO BOX 720
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06829-0720
Mailing Address - Country:US
Mailing Address - Phone:203-938-2820
Mailing Address - Fax:
Practice Address - Street 1:152 DEER HILL AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7791
Practice Address - Country:US
Practice Address - Phone:203-743-1724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT339103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT207.5100OtherDCF, PSYCHOLOGIST