MEDICARE: NEW HAVEN THERAPY, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073159372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HAVEN THERAPY, LLC.

Provider Business Mailing Address
First Line	:	110 WHEELER PATH
Second Line	:
City	:	GUILFORD
State	:	CT
Zip	:	06437-1206
Country	:	US
Telephone Number	:	267-334-3598
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 CENTRAL AVE STE 1
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06515-2168
Country	:	US
Telephone Number	:	203-807-4822
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. CAITLIN SORENSON
Credential	:	PSYD.
Telephone Number	:	267-334-3598

Provider Enumeration Date	:	11/21/2019
Last Update Date	:	11/21/2019

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Directions to “NEW HAVEN THERAPY, LLC. ” Practice Location

Language	Start Address	Practice Location

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