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General NPI Number Information
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NPI Number | 1699800045
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Entity Type | Organization
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Legal Business Name | ROBERT W BEHRENDS LLC
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 60 WESTWOOD AVE SUITE 210
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City | WATERBURY
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State | CT
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Zip | 06708-2460
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Country | US
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Telephone | 203-597-0633
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Fax | 203-755-5977
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Provider Business Mailing Address
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Address Line | 60 WESTWOOD AVE SUITE 210
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City | WATERBURY
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State | CT
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Zip | 06708-2460
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Country | US
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Telephone | 203-597-0633
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Fax | 203-755-5977
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. ROBERT W BEHRENDS
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Credential | M.D.
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Telephone | 203-597-0633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 020493
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License Number State | CT
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