Healthcare Provider Details

I. General information

NPI: 1447545231
Provider Name (Legal Business Name): COMPREHENSIVE PSYCHOLOGICAL & ASSESSMENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 TOWN LINE RD SUITE #101
WETHERSFIELD CT
06109-4352
US

IV. Provider business mailing address

55 TOWN LINE RD SUITE #101
WETHERSFIELD CT
06109-4352
US

V. Phone/Fax

Practice location:
  • Phone: 860-757-3702
  • Fax: 860-757-3725
Mailing address:
  • Phone: 860-757-3702
  • Fax: 860-757-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARGARITA HERNANDEZ
Title or Position: PSYCHOLOGIST/OWNER
Credential: P.H.D.
Phone: 860-757-3702