Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 002629 | CT |
N | 103T00000X | Psychologist | 002629 | CT |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 002629 | CT |
N | 103TA0700X | Adult Development & Aging Psychologist | 002629 | CT |
Y | 103G00000X | Clinical Psychologist | 002629 | CT |
Y | 103TC0700X | Clinical Psychologist | 002629 | CT |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 002629 | CT |
N | 103TF0000X | Family Psychologist | 002629 | CT |
N | 103TF0200X | Forensic Psychologist | 002629 | CT |
N | 103TP2701X | Group Psychotherapist | 002629 | CT |
NPI | 1457411068 |
---|---|
Provider Name | Dr. Claudio Negrao II |
First Address | Kensington, CT 06037-2172 |
Second Address | Kensington, CT 06037-5305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 29/03/2010 |