Healthcare Provider Details
I. General information
NPI: 1518142058
Provider Name (Legal Business Name): SPECTRUM PSYCHIATRIC GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/03/2008
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
60 WASHINGTON AVE 304
HAMDEN CT
06518-3271
US
IV. Provider business mailing address
60 WASHINGTON AVE 304
HAMDEN CT
06518-3271
US
V. Phone/Fax
- Phone: 203-281-2890
- Fax: 203-281-2896
- Phone: 203-281-2890
- Fax: 203-281-2896
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0808X |
| Taxonomy | Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CATHERINE
M
LINTON
Title or Position: PARTNER
Credential: LCSW
Phone: 203-281-2890