Provider Demographics
NPI:1356544191
Name:UNITED CEREBRAL PALSY OF SOUTHERN CONNECTICUT INC.
Entity type:Organization
Organization Name:UNITED CEREBRAL PALSY OF SOUTHERN CONNECTICUT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDERFELT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-269-3511
Mailing Address - Street 1:94-96 SOUTH TURNPIKE RD.
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-4322
Mailing Address - Country:US
Mailing Address - Phone:203-269-3511
Mailing Address - Fax:203-269-7411
Practice Address - Street 1:2326 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-1801
Practice Address - Country:US
Practice Address - Phone:203-333-3366
Practice Address - Fax:203-333-3364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00031583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty