Healthcare Provider Details

I. General information

NPI: 1578037347
Provider Name (Legal Business Name): CAITLYN PEARSON-DUNN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2019
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 E PUTNAM AVE STE H
COS COB CT
06807-2744
US

IV. Provider business mailing address

37 SHEEPHILL RD APT 12
RIVERSIDE CT
06878-1425
US

V. Phone/Fax

Practice location:
  • Phone: 203-536-9816
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CAITLYN D DUNN
Title or Position: MENTAL HEALTH THERAPIST
Credential: LCSW
Phone: 203-536-9816