1972758308 NPI number — MRS. DORI Y BESSETTE-CRAIL MA, LMFT

Table of content: MRS. DORI Y BESSETTE-CRAIL MA, LMFT (NPI 1972758308)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972758308 NPI number — MRS. DORI Y BESSETTE-CRAIL MA, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BESSETTE-CRAIL
Provider First Name:
DORI
Provider Middle Name:
Y
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BESSETTE
Provider Other First Name:
DORI
Provider Other Middle Name:
Y
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, MFT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1972758308
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
37 ALEXANDER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06040-3902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-402-8606
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
317 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06042-2007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-643-2101
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  1282 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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