Provider Demographics
NPI:1831333897
Name:EPS EDUCATIONAL AND PSYCHOLOGICAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:EPS EDUCATIONAL AND PSYCHOLOGICAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PSYCHOLOGICAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:NORRIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCHOLOGIST
Authorized Official - Phone:203-909-6194
Mailing Address - Street 1:85 WILLOW ST
Mailing Address - Street 2:BLDG 3, FIRST FLOOR, UNIT 1
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2668
Mailing Address - Country:US
Mailing Address - Phone:203-909-6194
Mailing Address - Fax:203-909-6462
Practice Address - Street 1:85 WILLOW ST
Practice Address - Street 2:BLDG 3, FIRST FLOOR, UNIT 1
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2668
Practice Address - Country:US
Practice Address - Phone:203-909-6194
Practice Address - Fax:203-909-6462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty