Provider Demographics
NPI:1982816526
Name:BARON THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:BARON THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR - SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC SLP
Authorized Official - Phone:203-387-1401
Mailing Address - Street 1:PO BOX 3568
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-0141
Mailing Address - Country:US
Mailing Address - Phone:203-387-1401
Mailing Address - Fax:
Practice Address - Street 1:15 RESEARCH DR
Practice Address - Street 2:UNIT #1
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2348
Practice Address - Country:US
Practice Address - Phone:203-387-1401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
CT002605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT660002605CT02OtherANTHEM PROVIDER #