Healthcare Provider Details

I. General information

NPI: 1497129407
Provider Name (Legal Business Name): JASON TARTT LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2015
Last Update Date: 07/20/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 MILL STREET BLDG. B SUITE 113
EAST BERLIN CT
06023-0602
US

IV. Provider business mailing address

BALANCE THERAPY SERVICES, LLC 32 HIGHLAND TERRACE
NEW BRITAIN CT
06053
US

V. Phone/Fax

Practice location:
  • Phone: 860-748-9443
  • Fax: 860-371-3840
Mailing address:
  • Phone: 860-989-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11998
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: