Healthcare Provider Details
I. General information
NPI: 1376837583
Provider Name (Legal Business Name): BARBARA GRETEN PSYCHOTHERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2011
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 ORCHARD ST SUITE 301
NEW HAVEN CT
06511-5363
US
IV. Provider business mailing address
85 BUTTERNUT DR
MERIDEN CT
06450-3509
US
V. Phone/Fax
- Phone: 203-859-2111
- Fax: 203-630-1177
- Phone: 203-859-2111
- Fax: 203-630-1177
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP1600X |
| Taxonomy | Pastoral Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 007312 |
| License Number State | CT |
VIII. Authorized Official
Name: MS.
BARBARA
J.
GRETEN
Title or Position: MENTAL HEALTH AND TRAUMA THERAPIST
Credential: M.DIV., MSW, LCSW
Phone: 203-859-2111