Black Locust Psychology PC
Psychologist, Clinical in East Haddam, Connecticut
1588460463- Practice location
- 29 Wickham RD, East Haddam, CT 06423-1204
- Phone
- 203-208-8641
- Fax
- —
- Last updated
- February 24, 2025
Black Locust Psychology PC is a healthcare organization based in East Haddam, CT. Black Locust Psychology PC practices in East Haddam, CT. The NPI Number for Black Locust Psychology PC is 1588460463. The current practice location address for Black Locust Psychology PC is 29 Wickham RD, East Haddam, CT 06423-1204 and can be reached out via phone at 203-208-8641.
Provider Profile Details
- NPI Number
- 1588460463
- Provider Name
- Black Locust Psychology PC
- Provider Entity Type
- Organization
- Address
- 29 Wickham RD, East Haddam, CT 06423-1204
- Phone Number
- 203-208-8641
- Primary Taxonomy
- Psychologist, Clinical · 103TC0700X
- Organization Subpart
- No
- Authorized Official
- Dr. Daniel Flack, JD, PHD · Sole Member · 203-208-8641
- Other Names
- Black Locust Psychology (Doing Business As)
- Provider Enumeration Date
- February 21, 2025
- Last Update Date
- February 24, 2025
- Certification Date
- February 24, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 29 Wickham RD
East Haddam, CT 06423-1204 - City
- East Haddam
- State
- Connecticut
- Zip
- 06423-1204
- Phone Number
- 203-208-8641
Provider Business Mailing Address Details
- Address
- 29 Wickham RD
East Haddam, CT 06423-1204 - City
- East Haddam
- State
- CT
- Zip
- 06423-1204
License Information
- Taxonomy (1)
- Psychologist, Clinical · 103TC0700X · Primary
- Taxonomy (2)
- Psychologist, Forensic · 103TF0200X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Psychologist, Clinical providers near East Haddam, CT
View all Psychologist, Clinical providers in East Haddam →- Dr. Wayne F Dailey, PHDPsychologist, Clinical · NPI 1336262732
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- Sherrie Gaudet, LCSW, LADCSocial Worker, Clinical · NPI 1083846356
- Hyeon-Ook KimCounselor, Mental Health · NPI 1538996129
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Frequently Asked Questions
What is the NPI number of Black Locust Psychology PC?
The NPI number of Black Locust Psychology PC is 1588460463. It was assigned on February 21, 2025 and is currently active in the NPPES registry.
What is the specialty of Black Locust Psychology PC?
Black Locust Psychology PC is registered under the primary taxonomy Psychologist, Clinical (code 103TC0700X).
Where does Black Locust Psychology PC practice?
The practice location is 29 Wickham RD, East Haddam, CT 06423-1204. The office can be reached at 203-208-8641 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1588460463 directly on the NPPES registry website.