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NPI Code Detail

MEDICARE: EASTER SEALS CAPITAL REGION & EASTERN CONNECTICUT, INC.

MEDICARE: EASTER SEALS CAPITAL REGION & EASTERN CONNECTICUT, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker
2103G00000XClinical Neuropsychologist
3103TC0700XClinical Psychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639177926
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTER SEALS CAPITAL REGION & EASTERN CONNECTICUT, INC.
Provider Business Mailing Address
First Line : 100 DEERFIELD RD
Second Line :
City : WINDSOR
State : CT
Zip : 06095-4252
Country : US
Telephone Number : 860-270-0600
Fax Number : 860-748-4432
Provider Business Practice Location Address
First Line : 100 DEERFIELD RD
Second Line :
City : WINDSOR
State : CT
Zip : 06095-4252
Country : US
Telephone Number : 860-270-0600
Fax Number : 860-748-4432
Authorized Official
Title or Position : PRESIDENT & CEO
Name : ROBIN SHARP
Credential :
Telephone Number : 860-270-0600
Provider Enumeration Date : 07/11/2005
Last Update Date : 03/26/2026

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