Healthcare Provider Details

I. General information

NPI: 1679410716
Provider Name (Legal Business Name): METTA INTEGRATIVE PSYCHOLOGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 W RIVER ST
MILFORD CT
06461-1917
US

IV. Provider business mailing address

945 W RIVER ST
MILFORD CT
06461-1917
US

V. Phone/Fax

Practice location:
  • Phone: 203-301-3330
  • Fax:
Mailing address:
  • Phone: 203-301-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CARMEN ROSA MARCANO-DAVIS
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 203-301-3330