Provider Demographics
NPI:1871970038
Name:ROBERT GRATTON PHD LCSW
Entity type:Organization
Organization Name:ROBERT GRATTON PHD LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LCSW
Authorized Official - Phone:203-245-0345
Mailing Address - Street 1:37 MIDDLESEX AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06412-1308
Mailing Address - Country:US
Mailing Address - Phone:203-245-0345
Mailing Address - Fax:860-526-5381
Practice Address - Street 1:37 MIDDLESEX AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:CT
Practice Address - Zip Code:06412-1308
Practice Address - Country:US
Practice Address - Phone:203-245-0345
Practice Address - Fax:860-526-5381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000322261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health