Provider Demographics
NPI:1235898305
Name:COMMUNICATION CONNECTIONS THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:COMMUNICATION CONNECTIONS THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAACSON
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:805-448-8112
Mailing Address - Street 1:2200 MARIE PARK DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-3641
Mailing Address - Country:US
Mailing Address - Phone:805-448-8112
Mailing Address - Fax:
Practice Address - Street 1:11000 CANDELARIA RD NE STE 105E
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1700
Practice Address - Country:US
Practice Address - Phone:805-448-8112
Practice Address - Fax:505-501-7483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1235602921Medicaid