Healthcare Provider Details

I. General information

NPI: 1033340302
Provider Name (Legal Business Name): JOANNE ELENA COMSTOCK PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 08/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 WINSTED RD WCMHN-TORRINGTON
TORRINGTON CT
06790-2958
US

IV. Provider business mailing address

249 WINSTED RD WCMHN-TORRINGTON
TORRINGTON CT
06790-2958
US

V. Phone/Fax

Practice location:
  • Phone: 860-496-3779
  • Fax: 860-496-3868
Mailing address:
  • Phone: 860-496-3779
  • Fax: 860-496-3868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number002949
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: