Provider Demographics
NPI:1457554644
Name:INSTITUTE FOR EDUCATIONAL PLANNING
Entity Type:Organization
Organization Name:INSTITUTE FOR EDUCATIONAL PLANNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MAYVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-876-5917
Mailing Address - Street 1:243 BROAD STREET
Mailing Address - Street 2:SUITE 7A
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460
Mailing Address - Country:US
Mailing Address - Phone:203-876-5917
Mailing Address - Fax:203-876-5919
Practice Address - Street 1:243 BROAD STREET
Practice Address - Street 2:SUITE 7A
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460
Practice Address - Country:US
Practice Address - Phone:203-876-5917
Practice Address - Fax:203-876-5919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002762103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty