Healthcare Provider Details

I. General information

NPI: 1952461477
Provider Name (Legal Business Name): AARON SARDELL PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 QUEEN ST
BRISTOL CT
06010-6379
US

IV. Provider business mailing address

291 QUEEN ST
BRISTOL CT
06010-6379
US

V. Phone/Fax

Practice location:
  • Phone: 413-447-9212
  • Fax:
Mailing address:
  • Phone: 413-347-9212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number003756
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6646
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: