Provider Demographics
NPI:1205375219
Name:SYNCT COLLABORATIVE THERAPY
Entity type:Organization
Organization Name:SYNCT COLLABORATIVE THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVOIE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:860-250-8054
Mailing Address - Street 1:123 LOWREY PLACE
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111
Mailing Address - Country:US
Mailing Address - Phone:860-233-3033
Mailing Address - Fax:858-924-0244
Practice Address - Street 1:123 LOWREY PLACE
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111
Practice Address - Country:US
Practice Address - Phone:860-233-3033
Practice Address - Fax:858-924-0244
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYNCT COLLABORATIVE THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-23
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-15-19112103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty