Provider Demographics
NPI:1548477961
Name:CENTER FOR DIALECTICAL AND COGNITIVE BEHAVIORAL THERAPIES, LLC
Entity type:Organization
Organization Name:CENTER FOR DIALECTICAL AND COGNITIVE BEHAVIORAL THERAPIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-787-3070
Mailing Address - Street 1:291 WHITNEY AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3724
Mailing Address - Country:US
Mailing Address - Phone:203-787-3070
Mailing Address - Fax:203-640-6449
Practice Address - Street 1:291 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3724
Practice Address - Country:US
Practice Address - Phone:203-787-3070
Practice Address - Fax:203-640-6449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT537103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty