Healthcare Provider Details

I. General information

NPI: 1275442733
Provider Name (Legal Business Name): TAINA COLON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SUMMER ST STE 202
STAMFORD CT
06905-5511
US

IV. Provider business mailing address

1111 SUMMER ST STE 202
STAMFORD CT
06905-5511
US

V. Phone/Fax

Practice location:
  • Phone: 203-487-0658
  • Fax:
Mailing address:
  • Phone: 203-487-0658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17299
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: