Provider Demographics
NPI:1174004758
Name:RISPOLI, TAYLOR CATHERINE (LPC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:CATHERINE
Last Name:RISPOLI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WHEELER ST
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-2219
Mailing Address - Country:US
Mailing Address - Phone:203-640-1013
Mailing Address - Fax:
Practice Address - Street 1:2228 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3256
Practice Address - Country:US
Practice Address - Phone:203-640-1013
Practice Address - Fax:203-640-1013
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT115101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical