Healthcare Provider Details

I. General information

NPI: 1295415503
Provider Name (Legal Business Name): CAILEE ROSE TALLON FIUME LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 SUMMER ST STE 200
STAMFORD CT
06905-5513
US

IV. Provider business mailing address

764 HOPE ST APT 2
STAMFORD CT
06907-2504
US

V. Phone/Fax

Practice location:
  • Phone: 203-482-0790
  • Fax:
Mailing address:
  • Phone: 203-482-0790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number16113
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: