Provider Demographics
NPI:1992858955
Name:CANTOR, DAVID JOSEPH (LMFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSEPH
Last Name:CANTOR
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 FARMINGTON AVE
Mailing Address - Street 2:2ND FL
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1670
Mailing Address - Country:US
Mailing Address - Phone:860-231-9690
Mailing Address - Fax:860-231-9690
Practice Address - Street 1:805 FARMINGTON AVE
Practice Address - Street 2:2ND FL
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-1670
Practice Address - Country:US
Practice Address - Phone:860-231-9690
Practice Address - Fax:860-231-9690
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000898106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT410000898CT03OtherANTHEM PROVIDER NUMBER