Provider Demographics
NPI:1992941660
Name:KAPLAN, CHARLES DAVID (PHD, LPC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:DAVID
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 ELLIS ST STE 3
Mailing Address - Street 2:C/O TODAY'S YOUTH, LLC
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3504
Mailing Address - Country:US
Mailing Address - Phone:860-740-6108
Mailing Address - Fax:
Practice Address - Street 1:162 THORPE AVE
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-4842
Practice Address - Country:US
Practice Address - Phone:203-235-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001510101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional