Provider Demographics
NPI:1508254418
Name:KERI SPIELMANN LLC
Entity Type:Organization
Organization Name:KERI SPIELMANN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SPIELMANN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:203-559-7023
Mailing Address - Street 1:900 ETHAN ALLEN HWY
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2826
Mailing Address - Country:US
Mailing Address - Phone:203-559-7023
Mailing Address - Fax:
Practice Address - Street 1:900 ETHAN ALLEN HWY
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-2826
Practice Address - Country:US
Practice Address - Phone:203-559-7023
Practice Address - Fax:203-702-5337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11314699103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty