Amy C Beaulieu, PSY.D.

Individual provider Active NPI Clinical Psychologist · Farmington, CT

NPI 1346574589 · NPPES record last updated May 6, 2019

Key facts

NPI
1346574589
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
002968 (CT)
Practice address
3 Forest Park Dr
Farmington, CT 06032-1468
Phone
(508) 654-0006
Fax
(860) 736-2048
NPI assigned
Sep 21, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
9262MAMDMental Health Counselor
002968CTMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 002968 CT Yes

Addresses

Primary practice location

3 Forest Park Dr
Farmington, CT 06032-1468

Mailing address

23 Wolf Hill Rd
Southington, CT 06489-3020
Phone (508) 654-0006

Other practice location 1

122 Wilmot Road
Behavioral Health
New Haven, CT 06515-0651
Phone (203) 503-3741

Other providers in Farmington, CT

All providers in Farmington, CT · Clinical Psychologist in Connecticut

Sources for this page

Verify at the official NPI Registry.