1376837583 NPI number — BARBARA GRETEN PSYCHOTHERAPY, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376837583 NPI number — BARBARA GRETEN PSYCHOTHERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARBARA GRETEN PSYCHOTHERAPY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376837583
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
85 BUTTERNUT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERIDEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06450-3509
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-859-2111
Provider Business Mailing Address Fax Number:
203-630-1177

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 ORCHARD ST
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06511-5363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-859-2111
Provider Business Practice Location Address Fax Number:
203-630-1177
Provider Enumeration Date:
06/06/2011

Additional Information

Authorized Official

Authorized Official Last Name:
GRETEN
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
MENTAL HEALTH AND TRAUMA THERAPIST
Authorized Official Telephone Number:
203-859-2111

Provider Taxonomy Codes

  • Taxonomy code: 101YP1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 007312 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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