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INTEGRATIVE PSYCHOLOGICAL CENTER LLC NPI 1306318670


NPI Information

NPI: 1306318670
Provider Name: INTEGRATIVE PSYCHOLOGICAL CENTER LLC
Classification: Psychologist - 103T00000X
Entity Type: Organization
Address:
44 CAPITOL AVE STE 402
HARTFORD, CT
ZIP 06106
Phone: (860) 466-9411
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INTEGRATIVE PSYCHOLOGICAL CENTER LLC is a psychologist in Hartford, CT. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. INTEGRATIVE PSYCHOLOGICAL CENTER LLC NPI is 1306318670. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

44 CAPITOL AVE STE 402
HARTFORD, CT
ZIP 06106-764
Phone: (860) 466-9411

The provider's authorized official is Randall Wallace .
The authorized official title is Owner/psychologist and has the following contact phone number (860) 466-9411.

The enumeration date for this NPI number is 12/26/2018 and was last updated on 12/26/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalNo
2103TF0200XPsychologistForensicNo
3103T00000XPsychologistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1008042490MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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