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General NPI Number Information
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NPI Number | 1720383318
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY PARTNERS, LLC
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Dates
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Enumeration Date | 01/13/2011
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 682 PROSPECT AVE FIRST FLOOR, BOX #5
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City | HARTFORD
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State | CT
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Zip | 06105-4238
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Country | US
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Telephone | 860-523-9011
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Fax | 860-523-9011
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Provider Business Mailing Address
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Address Line | 682 PROSPECT AVE FIRST FLOOR, BOX #5
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City | HARTFORD
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State | CT
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Zip | 06105-4238
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Country | US
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Telephone | 860-523-9011
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Fax | 860-523-9011
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELIZABETH L VITALE
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Credential | MSN, PSYD
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Telephone | 860-523-9011
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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 | 001898
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License Number State | CT
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