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Organization

BLACK LOCUST PSYCHOLOGY PC

Active
Other names
Black Locust Psychology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL FLACK JD, PHD (SOLE MEMBER)
(203) 208-8641
Entity
Organization

Contact information

Practice address
29 WICKHAM RD, EAST HADDAM, CT 06423-1204
(203) 208-8641
Mailing address
29 WICKHAM RD, EAST HADDAM, CT 06423-1204

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
103TF0200X
Forensic Psychologist

Other

Enumeration date
02/21/2025
Last updated
02/24/2025
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