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General NPI Number Information
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NPI Number | 1447440813
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Entity Type | Organization
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Legal Business Name | ANXIETY TREATMENT CENTER, LLC
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 6 FOREST PARK DR
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City | FARMINGTON
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State | CT
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Zip | 06032-1480
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Country | US
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Telephone | 860-269-7813
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Fax | 860-269-8621
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Provider Business Mailing Address
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Address Line | 6 FOREST PARK DR
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City | FARMINGTON
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State | CT
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Zip | 06032-1480
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Country | US
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Telephone | 860-269-7813
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Fax | 860-269-8621
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICHOLAS A MALTBY
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Credential | PH.D.
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Telephone | 860-269-7813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 002464
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 2956
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License Number State | CT
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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 | 2956
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 2878
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2878
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License Number State | CT
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Taxonomy #6
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3623
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License Number State | CT
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Taxonomy #7
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 3623
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License Number State | CT
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Taxonomy #8
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3478
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License Number State | CT
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Taxonomy #9
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 3478
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License Number State | CT
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Taxonomy #10
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2528
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License Number State | CT
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Taxonomy #11
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 2528
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License Number State | CT
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Taxonomy #12
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 002464
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License Number State | CT
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