Healthcare Provider Details

I. General information

NPI: 1952231763
Provider Name (Legal Business Name): ERIC PETERS PHD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ADDISON CIR
SUFFIELD CT
06078-1464
US

IV. Provider business mailing address

1 ADDISON CIR
SUFFIELD CT
06078-1464
US

V. Phone/Fax

Practice location:
  • Phone: 413-418-7691
  • Fax:
Mailing address:
  • Phone: 413-418-7691
  • 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. ERIC J PETERS
Title or Position: LIC. CLINICAL PSYCHOLOGIST/OWNE
Credential: PH.D.
Phone: 413-418-7691