Healthcare Provider Details

I. General information

NPI: 1861602609
Provider Name (Legal Business Name): DOUGLAS EUGENE SCARTH PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 OLD NEW MILFORD RD STE 1E
BROOKFIELD CT
06804-2426
US

IV. Provider business mailing address

2 OLD NEW MILFORD RD STE 1E
BROOKFIELD CT
06804-2426
US

V. Phone/Fax

Practice location:
  • Phone: 203-740-8078
  • Fax: 203-740-8890
Mailing address:
  • Phone: 203-740-8078
  • Fax: 203-740-8890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number001448
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: