Provider Demographics
NPI:1689860918
Name:CAPITAL KIDS THERAPIES
Entity Type:Organization
Organization Name:CAPITAL KIDS THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:FASTOSO
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-228-9160
Mailing Address - Street 1:124 HALL ST STE H
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3442
Mailing Address - Country:US
Mailing Address - Phone:603-228-9160
Mailing Address - Fax:603-224-2776
Practice Address - Street 1:124 HALL ST
Practice Address - Street 2:SUITE H
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3478
Practice Address - Country:US
Practice Address - Phone:603-228-9160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3075516Medicaid
NH21336YOtherUPIN