Healthcare Provider Details

I. General information

NPI: 1932834496
Provider Name (Legal Business Name): BARRY WASSERMAN, SCHOOL PSYCHOLOGY & COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 CURRIER DR
ORANGE CT
06477-2920
US

IV. Provider business mailing address

266 CURRIER DR
ORANGE CT
06477-2920
US

V. Phone/Fax

Practice location:
  • Phone: 203-988-3601
  • Fax: 203-799-7324
Mailing address:
  • Phone: 203-988-3601
  • Fax: 203-799-7324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BARRY L WASSERMAN
Title or Position: SCHOOL PSYCHOLOGIST & LPC
Credential: MS, LPC
Phone: 203-988-3601