Provider Demographics
NPI:1336344712
Name:KAUFMAN PSYCHOTHERAPY ASSOCIATES LLC
Entity type:Organization
Organization Name:KAUFMAN PSYCHOTHERAPY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-363-0793
Mailing Address - Street 1:970 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5542
Mailing Address - Country:US
Mailing Address - Phone:203-363-0793
Mailing Address - Fax:203-363-0794
Practice Address - Street 1:970 SUMMER ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5542
Practice Address - Country:US
Practice Address - Phone:203-363-0793
Practice Address - Fax:203-363-0794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT25971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1336344712OtherGOLDEN RULE
CT1336344712OtherCONNECTICARE
CT1336344712OtherPACIFICARE
1700914538OtherINDIVIDUAL NPI NUMBER
CT5335019OtherAETNA
CT1336344712OtherUNITED BEHAVIORAL HEALTH
CT403348OtherMHN
CT800004226OtherMEDICARE INDIVIDUAL PTAN
CTZS608OtherOXFORD
CT09441OtherCIGNA BEHAVIORAL HEALTH
CT140002597CT05OtherANTHEM LCSW
CT158568OtherGHI/ VALUE OPTIONS-BCBS
CT158568OtherVALUE OPTIONS
CT300000459CT05OtherANTHEM LADC
CT800004226OtherMEDICARE INDIVIDUAL PTAN