Provider Demographics
NPI:1912111824
Name:KIDZ MATTER LLC
Entity Type:Organization
Organization Name:KIDZ MATTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-749-9298
Mailing Address - Street 1:95 RAFFIA ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082
Mailing Address - Country:US
Mailing Address - Phone:860-749-9298
Mailing Address - Fax:860-749-9298
Practice Address - Street 1:95 RAFFIA ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082
Practice Address - Country:US
Practice Address - Phone:860-749-9298
Practice Address - Fax:860-749-9298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT104100000X
CT0058171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty