Healthcare Provider Details

I. General information

NPI: 1497025035
Provider Name (Legal Business Name): CT CLINICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 ORANGE ST
NEW HAVEN CT
06510-2014
US

IV. Provider business mailing address

189 ORANGE ST
NEW HAVEN CT
06510-2014
US

V. Phone/Fax

Practice location:
  • Phone: 203-937-2309
  • Fax:
Mailing address:
  • Phone: 203-479-3243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number0509
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number0425
License Number StateCT

VIII. Authorized Official

Name: BRETT TIBERIO
Title or Position: PRESIDENT
Credential:
Phone: 203-937-2309