Provider Demographics
NPI:1629519087
Name:C&D SENIOR INNOVATIONS LLC
Entity Type:Organization
Organization Name:C&D SENIOR INNOVATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CATHRYN
Authorized Official - Middle Name:C
Authorized Official - Last Name:STETTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:336-575-0410
Mailing Address - Street 1:165 CALIFORNIA RD
Mailing Address - Street 2:#11
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-6559
Mailing Address - Country:US
Mailing Address - Phone:336-575-0410
Mailing Address - Fax:
Practice Address - Street 1:165 CALIFORNIA RD
Practice Address - Street 2:#11
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-6559
Practice Address - Country:US
Practice Address - Phone:336-575-0410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X
PACW0173171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty