Healthcare Provider Details

I. General information

NPI: 1982434122
Provider Name (Legal Business Name): TALINE ANDONIAN PSY.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 S HIGHLAND ST
WEST HARTFORD CT
06119-1826
US

IV. Provider business mailing address

17 S HIGHLAND ST
WEST HARTFORD CT
06119-1826
US

V. Phone/Fax

Practice location:
  • Phone: 516-582-3240
  • Fax:
Mailing address:
  • Phone: 516-582-3240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TALINE ANDONIAN
Title or Position: CLINICAL PSYCHOLOGIST, OWNER
Credential: PSY.D.
Phone: 516-582-3240