Healthcare Provider Details

I. General information

NPI: 1467623157
Provider Name (Legal Business Name): BRUCE FRANKLIN SINGER PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FORTY ACRE MOUNTAIN RD
DANBURY CT
06811-3353
US

IV. Provider business mailing address

100 FORTY ACRE MOUNTAIN RD
DANBURY CT
06811-3353
US

V. Phone/Fax

Practice location:
  • Phone: 707-304-4368
  • Fax:
Mailing address:
  • Phone: 707-304-4368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number3151
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number003151
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number003151
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: