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General NPI Number Information
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NPI Number | 1164158085
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Entity Type | Organization
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Legal Business Name | ALLIANCE - PSYCHOLOGY ADVOCACY & SUPPORT LLC
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Dates
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Enumeration Date | 07/25/2022
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 195 S MAIN ST STE 5
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City | CHESHIRE
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State | CT
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Zip | 06410-3171
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Country | US
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Telephone | 203-232-7956
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Fax | 203-298-6254
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Provider Business Mailing Address
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Address Line | 1393 DIAMOND HILL RD
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City | CHESHIRE
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State | CT
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Zip | 06410-1899
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Country | US
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Telephone | 203-232-7956
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Fax | 203-298-6254
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. KEVIN COLWELL
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Credential | PH.D.
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Telephone | 203-232-7956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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