Provider Demographics
NPI:1891219648
Name:LINDA J TALBERT LLC
Entity Type:Organization
Organization Name:LINDA J TALBERT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:203-899-0745
Mailing Address - Street 1:161 EAST AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5710
Mailing Address - Country:US
Mailing Address - Phone:203-899-0745
Mailing Address - Fax:203-204-6931
Practice Address - Street 1:161 EAST AVE STE 104
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5710
Practice Address - Country:US
Practice Address - Phone:203-899-0745
Practice Address - Fax:203-204-6931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-26415103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty