Provider Demographics
NPI:1205972528
Name:BESSETTE, ANDRE P (PHD)
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:P
Last Name:BESSETTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 E QUASSET RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:CT
Mailing Address - Zip Code:06281-3306
Mailing Address - Country:US
Mailing Address - Phone:860-933-6697
Mailing Address - Fax:860-456-4068
Practice Address - Street 1:155A STORRS RD.
Practice Address - Street 2:A
Practice Address - City:MANSFIELD CENTER
Practice Address - State:CT
Practice Address - Zip Code:06250
Practice Address - Country:US
Practice Address - Phone:860-456-4442
Practice Address - Fax:860-456-4068
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002738103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical