Provider Demographics
NPI:1023658184
Name:ROSEANN CAPANNA-HODGE, LLC
Entity type:Organization
Organization Name:ROSEANN CAPANNA-HODGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSEANN
Authorized Official - Middle Name:CAPANNA
Authorized Official - Last Name:CAPANNA-HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:203-438-4848
Mailing Address - Street 1:898 ETHAN ALLEN HWY STE 6
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2831
Mailing Address - Country:US
Mailing Address - Phone:203-438-4848
Mailing Address - Fax:
Practice Address - Street 1:898 ETHAN ALLEN HWY STE 6
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-2831
Practice Address - Country:US
Practice Address - Phone:203-438-4848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty