Provider Demographics
NPI:1295479764
Name:ADVANCED PSYCHOTHERAPY SERVICES, LLC
Entity type:Organization
Organization Name:ADVANCED PSYCHOTHERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAILIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BATON-KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-348-5589
Mailing Address - Street 1:599 WESTCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-2229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:599 WESTCHESTER RD
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-2229
Practice Address - Country:US
Practice Address - Phone:860-348-5589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty