Provider Demographics
NPI:1881895670
Name:PSYCHOTHERAPY ASSOCIATES OF WESTERN CONNECTICUT
Entity type:Organization
Organization Name:PSYCHOTHERAPY ASSOCIATES OF WESTERN CONNECTICUT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ERHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MSLMFT
Authorized Official - Phone:203-740-2595
Mailing Address - Street 1:246 FEDERAL RD
Mailing Address - Street 2:C-24
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2647
Mailing Address - Country:US
Mailing Address - Phone:203-740-2595
Mailing Address - Fax:203-740-2287
Practice Address - Street 1:246 FEDERAL RD
Practice Address - Street 2:C-24
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2647
Practice Address - Country:US
Practice Address - Phone:203-740-2595
Practice Address - Fax:203-740-2287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000218CT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty