Organization
SPECTRUM PSYCHOTHERAPY CENTERS, LLC
Active
Organization
SPECTRUM PSYCHOTHERAPY CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER PENTA PSY.D. (PRESIDENT)
(860) 246-7999
Entity
Organization
Contact information
Practice address
41 MECHANIC ST, WINDSOR, CT 06095-2545
(860) 246-7999
(860) 688-0004
Mailing address
30 MAPLE AVE, WINDSOR, CT 06095-2922
(860) 246-7999
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2490549
AETNA US HEALTHCARE
CT
01
—
252147
MHN
CT
01
—
ANC1198
OXFORD HEALTH PLANS
CT
Enumeration date
08/15/2006
Last updated
10/02/2014
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