Provider Demographics
NPI:1518486059
Name:MEASURABLE PROGRESS THERAPY, LLC
Entity Type:Organization
Organization Name:MEASURABLE PROGRESS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:I
Authorized Official - Last Name:MULHALL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-598-4707
Mailing Address - Street 1:192 CAMPVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06778-2218
Mailing Address - Country:US
Mailing Address - Phone:203-598-4707
Mailing Address - Fax:888-453-0519
Practice Address - Street 1:100 WHITING ST # 409
Practice Address - Street 2:
Practice Address - City:WINSTED
Practice Address - State:CT
Practice Address - Zip Code:06098-1878
Practice Address - Country:US
Practice Address - Phone:203-598-4707
Practice Address - Fax:888-453-0519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0070641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008049711Medicaid