Provider Demographics
NPI:1447545231
Name:COMPREHENSIVE PSYCHOLOGICAL & ASSESSMENT SERVICES LLC
Entity type:Organization
Organization Name:COMPREHENSIVE PSYCHOLOGICAL & ASSESSMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-757-3702
Mailing Address - Street 1:55 TOWN LINE RD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4352
Mailing Address - Country:US
Mailing Address - Phone:860-757-3702
Mailing Address - Fax:860-757-3725
Practice Address - Street 1:55 TOWN LINE RD
Practice Address - Street 2:SUITE #101
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4352
Practice Address - Country:US
Practice Address - Phone:860-757-3702
Practice Address - Fax:860-757-3725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysisGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT002171OtherLICENSE