Provider Demographics
NPI:1437410800
Name:PEGGY-SUE FORSTER, LLC
Entity Type:Organization
Organization Name:PEGGY-SUE FORSTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY-SUE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FORSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-984-1126
Mailing Address - Street 1:2537 POST RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06890-1242
Mailing Address - Country:US
Mailing Address - Phone:203-984-1126
Mailing Address - Fax:860-567-2195
Practice Address - Street 1:2551 POST RD
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:CT
Practice Address - Zip Code:06890-1217
Practice Address - Country:US
Practice Address - Phone:203-984-1126
Practice Address - Fax:860-567-2195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001441106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty