Provider Demographics
NPI:1528322773
Name:AUDETTE & ASSOCIATES LLC
Entity type:Organization
Organization Name:AUDETTE & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:AUDETTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MS
Authorized Official - Phone:203-733-5953
Mailing Address - Street 1:400 MAIN ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-3004
Mailing Address - Country:US
Mailing Address - Phone:203-733-5953
Mailing Address - Fax:203-733-5953
Practice Address - Street 1:400 MAIN ST
Practice Address - Street 2:SUITE 813
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-3004
Practice Address - Country:US
Practice Address - Phone:203-733-5953
Practice Address - Fax:203-733-5953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty