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General NPI Number Information
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NPI Number | 1609170711
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL AND COGNITIVE TREATMENT ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 270 FARMINGTON AVE SUITE 313
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City | FARMINGTON
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State | CT
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Zip | 06032-1909
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Country | US
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Telephone | 860-404-2040
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Fax | 860-404-2040
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Provider Business Mailing Address
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Address Line | 270 FARMINGTON AVE SUITE 313
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City | FARMINGTON
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State | CT
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Zip | 06032-1909
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Country | US
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Telephone | 860-404-2040
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Fax | 860-404-2040
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Authorized Official
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Title or Position | OWNER
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Name | JOHN R SAKSA
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Credential | PSY.D.
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Telephone | 860-404-2040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 002296
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License Number State | CT
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